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脾脏 Rosai-Dorfman 病极为罕见。

An extremely rare case of Rosai-Dorfman disease in the spleen.

机构信息

Binhai Hospital of Tianjin Medical University General Hospital, Tianjin, China.

Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China.

出版信息

BMC Surg. 2021 Jan 6;21(1):24. doi: 10.1186/s12893-020-01014-0.

Abstract

BACKGROUND

Rosai-Dorfman disease (RDD) is a rare, multisystemic histiocytic disorder, and commonly manifesting as lymphadenopathy in the young male. Abdominal manifestations of RDD are extremely rare.

CASE PRESENTATION

In August 2018, a 42-year-old man underwent an abdominal ultrasonography examination due to his weight loss of 10 kg in only three months and found a giant solid tumor was found in his spleen. Then, he was admitted to our hospital and diagnosed as a splenic mass via abdominal enhanced CT and MRI. Laparoscopic splenectomy was administrated within six days of admission due to the clear surgical indications. The pathogenesis of RDD remained poorly understood and the disease should be diagnosed based on histopathology and immunohistochemistry (IHC). The mutations in ATM and NFKBIA were observed using next generation sequencing (NGS).

CONCLUSION

We reported a case of splenic involvement of RDD with NGS genetic testing, indicating the difficulty of making a diagnosis before surgery. This extremely rare case offers new references for the understanding of abdominal viscera RDD.

摘要

背景

罗萨-多夫曼病(RDD)是一种罕见的多系统组织细胞增生症,通常表现为年轻男性的淋巴结病。RDD 的腹部表现极为罕见。

病例介绍

2018 年 8 月,一名 42 岁男性因体重在三个月内减轻 10 公斤而接受腹部超声检查,发现脾脏内有一个巨大的实性肿瘤。随后,他被收入我院,通过腹部增强 CT 和 MRI 诊断为脾肿块。由于明确的手术指征,入院后 6 天内进行了腹腔镜脾切除术。RDD 的发病机制尚不清楚,应根据组织病理学和免疫组织化学(IHC)进行诊断。使用下一代测序(NGS)观察 ATM 和 NFKBIA 的突变。

结论

我们报告了一例伴有 NGS 基因检测的脾 RDD 病例,表明术前诊断困难。这个极其罕见的病例为理解腹部内脏 RDD 提供了新的参考。

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