Kang Mao-Ji, Zhang Jin-Chang, Fang Cheng, Li Bo, Su Song
Department of General Surgery (Hepatopancreatobiliary surgery), The Affiliated Hospital of Southwest Medical University, Sichuan, China.
Front Oncol. 2024 Feb 12;14:1343157. doi: 10.3389/fonc.2024.1343157. eCollection 2024.
Castleman disease (CD), a distinct lymphoproliferative disorder, is infrequently encountered in clinical practice and poses significant diagnostic challenges. We present the case of a 48-year-old asymptomatic female, admitted for evaluation of a hepatic mass detected in the liver's right lobe. Preoperative laboratory tests were within normal limits. Diagnostic imaging, including contrast-enhanced magnetic resonance imaging (MRI), was suggestive of hepatocellular carcinoma. Furthermore, contrast-enhanced abdominal computed tomography (CT) scans were indicative of hepatic malignancy. Subsequently, the patient underwent laparoscopic surgery targeting a retroperitoneal mass. During the surgical procedure, it was observed that the tumor was a retroperitoneal mass situated posterior to the liver, exhibiting localized adhesion to hepatic tissue. The postoperative histopathological analysis revealed the mass to be hyaline-vascular type Castleman disease (HV-CD), thereby refuting the initial diagnosis of a hepatic malignancy. This case underscores the complexity of diagnosing retroperitoneal Castleman disease, particularly when it masquerades as a hepatic tumor.
卡斯特曼病(CD)是一种独特的淋巴增殖性疾病,在临床实践中很少见,并且带来了重大的诊断挑战。我们报告一例48岁无症状女性病例,该患者因评估在肝脏右叶发现的肝脏肿块而入院。术前实验室检查结果均在正常范围内。包括对比增强磁共振成像(MRI)在内的诊断性影像学检查提示为肝细胞癌。此外,腹部对比增强计算机断层扫描(CT)扫描显示为肝脏恶性肿瘤。随后,患者接受了针对腹膜后肿块的腹腔镜手术。在手术过程中,观察到肿瘤是位于肝脏后方的腹膜后肿块,与肝组织有局部粘连。术后组织病理学分析显示该肿块为透明血管型卡斯特曼病(HV-CD),从而推翻了最初肝脏恶性肿瘤的诊断。该病例强调了诊断腹膜后卡斯特曼病的复杂性,尤其是当它伪装成肝脏肿瘤时。