Chauveau Bertrand, Le Loarer François, Bacci Julia, Baylac François, Dubus Pierre, Ling Catherine, Parrens Marie
Service de pathologie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue Magellan, 33600 Pessac, France; Université de Bordeaux, Campus de Carreire, 146, rue Léo-Saignat CS 61292, 33076 Bordeaux cedex, France.
Service de biopathologie, institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France; Université de Bordeaux, Campus de Carreire, 146, rue Léo-Saignat CS 61292, 33076 Bordeaux cedex, France.
Ann Pathol. 2019 Feb;39(1):29-35. doi: 10.1016/j.annpat.2018.09.003. Epub 2018 Dec 13.
Herein we report the case of a 41-year-old woman who presented with pelvic pain. Magnetic Resonance Imaging exhibited a single pelvic mass, measuring 50mm long axis, alongside the right iliac vessels. Histological examination of the excision specimen showed a lymphoid tumor with features of localized Castleman disease, hyaline vascular type. Moreover we identified multiple interfollicular dark clusters, composed of cells morphologically resembling cortical thymocytes. Their immunophenotype was consistent with an intermediate stage of T-cell differentiation, with the expression of CD3, CD4, CD8, TdT, CD1a, CD99, CD2, CD5, CD7 and CD10, with 40% Ki67. After integration of clinical and molecular data, the retained diagnosis was an indolent T-cell lymphoblastic proliferation associated with hyaline vascular localized Castleman disease. The clinical course confirmed the indolent nature of the proliferation, despite a late local recurrence at 7 years of the initial diagnosis, without histological modification, due to an incomplete initial resection surgery.
在此，我们报告一例41岁出现盆腔疼痛的女性病例。磁共振成像显示在右髂血管旁有一个长轴为50mm的单一盆腔肿块。切除标本的组织学检查显示为具有局限性透明血管型Castleman病特征的淋巴样肿瘤。此外，我们发现多个滤泡间暗细胞簇，由形态上类似于皮质胸腺细胞的细胞组成。它们的免疫表型与T细胞分化的中间阶段一致，表达CD3、CD4、CD8、TdT、CD1a、CD99、CD2、CD5、CD7和CD10，Ki67为40%。综合临床和分子数据后，最终诊断为与透明血管型局限性Castleman病相关的惰性T细胞淋巴母细胞增殖。临床病程证实了该增殖的惰性本质，尽管在初始诊断7年后出现局部复发较晚，且由于初始切除手术不完全，组织学未发生改变。
