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人类免疫缺陷病毒感染中的多中心Castleman病:两例报告。

Multicentric Castleman's disease in human immunodeficiency virus infection: two case reports.

作者信息

Caroline Ribeiro Sales Amanda, Romão de Souza Junior Valter, Iglis de Oliveira Marta, Azevedo Braga Albuquerque Claudia, de Barros Campelo Júnior Evônio, Sérgio Ramos de Araújo Paulo

机构信息

Federal University of Pernambuco, Av. Prof. Moraes Rego 1235, Recife, 50670-901, Brazil.

University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK.

出版信息

J Med Case Rep. 2018 May 5;12(1):117. doi: 10.1186/s13256-018-1656-5.

Abstract

BACKGROUND

Castleman's Disease is a rare B-cell lymphoproliferative disease. It is mostly benign and is characterized by non-neoplastic lymph node hypertrophy, associated with infection by human herpesvirus-8 in people with the human immunodeficiency virus/acquired immunodeficiency syndrome. Although the unicentric or localized form presents as benign, the multifocal form can manifest severe systemic symptoms. We report two unusual cases of men presenting cervical enlarged lymph nodes that were believed to be infectious.

CASE PRESENTATION

The first case is a 41-year-old feoderm man who presented to the Department of Infectious Diseases of the Hospital das Clínicas in May 2015, with irregular fever history (38-39 °C), dyspnea, weight loss (8 kg/1 year), and asthenia with increased cervical lymph nodes of 1-year duration. His immunohistochemical diagnosis presented Castleman's disease in plasmacytic/diffuse form. In the second case, a 35-year-old feoderm man presented at the same hospital with multiple cervical enlarged lymph nodes and histopathological evidence of Castleman's disease associated with human herpesvirus-8.

CONCLUSION

Considering the importance of differential diagnosis of lymphoid disorders, Castleman's disease is a challenging diagnosis in people living with human immunodeficiency virus/acquired immunodeficiency syndrome and can be easily misdiagnosed when lymphoid disorders are present in the human immunodeficiency virus/acquired immunodeficiency syndrome population due to nonspecific symptoms and signs.

摘要

背景

卡斯特曼病是一种罕见的B细胞淋巴增殖性疾病。它大多为良性,其特征是非肿瘤性淋巴结肥大,在人类免疫缺陷病毒/获得性免疫缺陷综合征患者中与人类疱疹病毒8型感染有关。尽管单中心或局限性形式表现为良性,但多灶性形式可表现出严重的全身症状。我们报告了两例不寻常的男性病例,他们出现颈部淋巴结肿大,最初被认为是感染性的。

病例介绍

第一例是一名41岁的男性,2015年5月就诊于临床医院传染病科,有不规则发热史(38 - 39°C)、呼吸困难、体重减轻(1年内减轻8公斤)以及乏力,颈部淋巴结肿大已有1年。其免疫组化诊断为浆细胞型/弥漫型卡斯特曼病。第二例是一名35岁的男性,在同一家医院就诊,有多处颈部淋巴结肿大,组织病理学证据显示为与人类疱疹病毒8型相关的卡斯特曼病。

结论

考虑到淋巴系统疾病鉴别诊断的重要性,卡斯特曼病在人类免疫缺陷病毒/获得性免疫缺陷综合征患者中是一个具有挑战性的诊断,由于该人群中存在非特异性症状和体征,当出现淋巴系统疾病时很容易被误诊。

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本文引用的文献

1
Update and new approaches in the treatment of Castleman disease.卡斯特曼病治疗的最新进展与新方法
J Blood Med. 2016 Aug 3;7:145-58. doi: 10.2147/JBM.S60514. eCollection 2016.
2
Multicentric Castleman disease: Where are we now?多中心性Castleman病:我们目前的进展如何?
Semin Diagn Pathol. 2016 Sep;33(5):294-306. doi: 10.1053/j.semdp.2016.05.006. Epub 2016 May 16.
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Fifty years of multicentric Castleman's disease.五十年的多中心性Castleman病。
Acta Oncol. 2004;43(8):698-704. doi: 10.1080/02841860410002752.
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The clinical behavior of localized and multicentric Castleman disease.局限性和多中心性Castleman病的临床行为
Ann Intern Med. 1998 Apr 15;128(8):657-62. doi: 10.7326/0003-4819-128-8-199804150-00010.

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