Rizzo Stéphanie, Camboni Alessandra, Van Eeckhout Pascal, Collins Patrick, Somja Joan
Service d'anatomie et cytologie pathologiques, CHU de Liège, site Sart-Tilman, 4000 Liège, Belgique.
Service d'anatomie et cytologie pathologiques, cliniques universitaires Saint-Luc, 1200 Bruxelles, Belgique.
Ann Pathol. 2024 Mar;44(2):130-136. doi: 10.1016/j.annpat.2023.09.005. Epub 2023 Oct 3.
Castleman's disease is a rare and benign lymphoproliferative disorder which can be unicentric (UCD) or multicentric (MCD). UCD usually involves a single lymph node or less frequently a group of lymph nodes. The most common sites of nodal UCD presentation are the mediastinum, neck, abdomen and retroperitoneum. Rarely extranodal involvement has been reported. The intramuscular location is very unusual with only about 10 cases described in medical literature so far.
We present a case of atypical localization of Castleman's disease occurring in the right gluteal area in a 40-years-old female patient. The patient was asymptomatic and clinical examination was unremarkable except for a right gluteal palpable mass. The CT scanner-guided needle core biopsy was inconclusive. A surgical excision was then performed that revealed a hyaline-vascular type of Castleman's disease. The patient has an uneventful post-operative course.
The present case is instructive in the work-up of primary soft tissue tumors, for which Castleman's disease is extremely rare and not considered in the differential diagnosis of clinicians. Pathologists must be aware of its existence so that it can be evoked in the presence of a lymphoid population on histological examination.
Castleman病是一种罕见的良性淋巴增生性疾病,可分为单中心型(UCD)或多中心型(MCD)。UCD通常累及单个淋巴结,较少累及一组淋巴结。UCD淋巴结受累最常见的部位是纵隔、颈部、腹部和腹膜后。很少有结外受累的报道。肌肉内受累非常罕见,迄今为止医学文献中仅描述了约10例。
我们报告一例40岁女性患者,Castleman病发生在右臀区域的非典型定位。患者无症状,除右臀可触及肿块外,临床检查无异常。CT引导下的针芯活检结果不明确。随后进行了手术切除,结果显示为透明血管型Castleman病。患者术后恢复顺利。
本病例对原发性软组织肿瘤的检查具有指导意义,Castleman病极为罕见,临床医生在鉴别诊断时不会考虑。病理学家必须意识到它的存在,以便在组织学检查发现淋巴样细胞群时能够想到该病。