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木村病,腹股沟淋巴结病的罕见病因:一例报告。

Kimura disease, a rare cause of inguinal lymphadenopathy: A case report.

作者信息

Hu Xianwen, Li Xue, Yang Changwei, Li Dandan, Cai Jiong, Wang Pan

机构信息

Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China.

Department of Obstetrics, Zunyi Hospital of Traditional Chinese Medicine, Zunyi, China.

出版信息

Front Med (Lausanne). 2022 Sep 23;9:1023804. doi: 10.3389/fmed.2022.1023804. eCollection 2022.

Abstract

Kimura's disease (KD) is a rare chronic granulomatous disease of unknown etiology that mainly involves damage to lymph nodes, soft tissues, and salivary glands. The clinical symptoms are mainly painless subcutaneous soft tissue masses, often involving head and neck lymph nodes and salivary glands, and are mainly characterized by diffuse eosinophilic infiltration, lymphocyte, and vascular proliferation. There are few reports in the literature that KD affects only inguinal lymph nodes. We report in this study a 41-year-old male patient who presented to the hospital for medical help with soft tissue masses in the groin. Magnetic resonance imaging (MRI) showed multiple abnormal soft tissue nodules around the iliac vessels in the left groin, and a contrast-enhanced scan showed obvious homogeneous enhancement. Diffusion-weighted imaging showed limited movement of water molecules and showed an obvious high signal. Fluoro18-labeled deoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) was recommended for further evaluation of the patient's general condition, and the results showed that except for the radioactive uptake in the lesions in the left groin region, no obvious abnormality was found in the rest of the body. Based on these imaging findings, the patient was first suspected to have malignant lesions, and then the patient underwent histopathological examination, which was confirmed to be KD. Our case study suggests that KD affects only the inguinal lymph nodes is rare and should be considered as one of the imaging differential diagnoses for lymphadenopathy such as lymphoma, metastases, and Castleman's disease.

摘要

木村病(KD)是一种病因不明的罕见慢性肉芽肿性疾病,主要累及淋巴结、软组织和唾液腺。临床症状主要为无痛性皮下软组织肿块,常累及头颈部淋巴结和唾液腺,主要特征为弥漫性嗜酸性粒细胞浸润、淋巴细胞及血管增生。文献中鲜有KD仅累及腹股沟淋巴结的报道。我们在本研究中报告了一名41岁男性患者,因腹股沟软组织肿块前来医院就医。磁共振成像(MRI)显示左侧腹股沟髂血管周围有多个异常软组织结节,增强扫描显示明显均匀强化。扩散加权成像显示水分子运动受限,呈明显高信号。建议行氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描(F-FDG PET/CT)进一步评估患者全身情况,结果显示除左侧腹股沟区病变有放射性摄取外,身体其他部位未发现明显异常。基于这些影像学表现,该患者最初被怀疑患有恶性病变,随后患者接受了组织病理学检查,确诊为KD。我们的病例研究表明,KD仅累及腹股沟淋巴结较为罕见,应被视为淋巴瘤、转移瘤和Castleman病等淋巴结病的影像学鉴别诊断之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cebb/9537629/a27987e34c1c/fmed-09-1023804-g001.jpg

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