Harmankaya İsmail, Ugras Nevzat Serdar, Sekmenli Tamer, Demir Fatih, Köksal Yavuz
Selçuk University, Faculty of Medicine, Department of Pathology. Konya, Turkey.
Selçuk University, Faculty of Medicine, Department of Pediatric Surgery. Konya, Turkey.
Autops Case Rep. 2018 Jul 30;8(3):e2018033. doi: 10.4322/acr.2018.033. eCollection 2018 Jul-Sep.
Simultaneous calcified fibrous pseudotumor (CFT) and Castleman disease (CD) is an extremely rare association. CD is an uncommon lymphoproliferative disease that can arise in various sites of the body, while CFT is a rare type of benign fibrous lesion that frequently affects children and young adults, occurring as solitary or multiple lesions throughout the human body. Both entities are rare and exhibit typical and diverse histomorphological features. We report the case of a 15-year-old female patient, who, at the age of 13 had a biopsy performed at an external medical center; however, after 4 months the lesion had regrown. This lesion was removed with a surgical operation; however, it regrew 2 years later and was removed a third time. The results of the latter two biopsies were the same: CFT accompanying CD. The histologic examination of the excised lymph node and the surrounding tissue showed hyalinized fibrous tissue containing dystrophic and psammomatous calcification. In this case, the hyaline vascular type of CD was found to be intertwined with a CFT, which hampered the differentiation of whether both entities emerged within the lymph node or if the CFT developed from the soft tissue and then involved the lymph node. Future studies involving larger case series will provide a more precise insight, which should serve to resolve the current uncertainty.
同时发生钙化性纤维性假瘤(CFT)和Castleman病(CD)极为罕见。CD是一种不常见的淋巴增殖性疾病,可发生于身体的各个部位,而CFT是一种罕见的良性纤维性病变,常影响儿童和年轻人,以全身单发或多发病变形式出现。这两种疾病均罕见,且具有典型且多样的组织形态学特征。我们报告一例15岁女性患者,她13岁时在外部医疗中心接受活检;然而,4个月后病变复发。该病变通过手术切除;但2年后复发,再次切除。后两次活检结果相同:CFT伴发CD。对切除的淋巴结及周围组织进行组织学检查,显示玻璃样变的纤维组织伴有营养不良性和砂粒体样钙化。在该病例中,发现透明血管型CD与CFT相互交织,这使得难以区分这两种病变是均起源于淋巴结,还是CFT起源于软组织然后累及淋巴结。未来涉及更大病例系列的研究将提供更精确的见解,有助于解决当前的不确定性。