Sbrana Fabio, Zhou Dimin, Zamfirova Ina, Leonardi Nathaniel
Department of Surgery, Advocate Lutheran General Hospital, Park Ridge, IL 60068, USA.
Chicago Medical School, Rosalind Franklin University, North Chicago, IL 60064, USA.
J Surg Case Rep. 2017 Oct 9;2017(10):rjx195. doi: 10.1093/jscr/rjx195. eCollection 2017 Oct.
Unicentric Castleman's disease (UCD) is a rare disorder of unknown etiology characterized by localized lymphoid tissue proliferation and interfollicular hypervascularity. A 33-year-old Caucasian female presented with vague abdominal discomfort and pain with pressure. Ultrasound and computed tomography detected a large peripancreatic mass. Robotic-assisted resection of the mass along with en bloc dissection of the encased left adrenal gland was done. Frozen section examination confirmed UCD hyaline vascular variant in a retroperitoneal accessory spleen. Preoperative diagnosis of UCD is difficult due to its lack of specific symptoms and its cytologic similarity to reactive lymphadenopathy and other lymphoproliferative disorders. Surgical resection is standard treatment and provides the pathological specimen required for diagnostic confirmation. Here, robotic-assisted laparoscopy allowed visualization, mobilization, precise resection and extraction of the mass from a difficult to access retroperitoneal region.
单中心Castleman病（UCD）是一种病因不明的罕见疾病，其特征为局限性淋巴组织增生和滤泡间血管增多。一名33岁的白种女性出现腹部隐痛和压痛。超声和计算机断层扫描发现胰周有一个大肿块。通过机器人辅助对肿块进行了切除，并将包裹的左肾上腺一并整块切除。冰冻切片检查证实腹膜后副脾为UCD透明血管型。由于UCD缺乏特异性症状，且在细胞学上与反应性淋巴结病及其他淋巴增生性疾病相似，因此术前诊断困难。手术切除是标准治疗方法，可提供确诊所需的病理标本。在此病例中，机器人辅助腹腔镜检查能够实现对位于难以到达的腹膜后区域的肿块进行可视化、游离、精确切除和取出。
