Department of Gastroenterology, Lokamanya Tilak Municipal Medical College, Mumbai, Maharashtra, India.
Department of Medicine, Lokamanya Tilak Municipal Medical College, Mumbai, Maharashtra, India.
J Cancer Res Ther. 2024 Jul 1;20(5):1602-1604. doi: 10.4103/jcrt.jcrt_2190_22. Epub 2023 Apr 4.
An elderly man presented with fever and chills for six months, associated with loss of appetite and weight loss, bilateral edema, and non-tender inguinal lymphadenopathy. The left-sided testicle was bulky, firm, and non-tender. Investigations revealed anemia, leukopenia, elevated erythrocyte sedimentation rate, and hypergammaglobulinemia. Ultrasound of the abdomen revealed multiple enlarged necrotic lymph nodes in the periaortic, preaortic, precaval, and bilateral pelvic regions. Fine-needle aspiration cytology (FNAC) of the inguinal nodes showed no acid-fast bacilli (AFB). However, excision biopsy revealed lymphoid tissue with effacement of architecture by diffuse proliferation of mature plasma cells, suggestive of the plasma cell variant of multicentric Castleman disease. Due to suspicion of neoplastic testicular enlargement, the patient underwent bilateral orchidectomy, and histopathology showed hematocele with atrophy of the testis and secondary involvement of the testicular parenchyma by plasma cell variant of Castleman disease.
一位老年男性因发热、寒战就诊，伴有食欲不振和体重减轻、双侧水肿和非触痛性腹股沟淋巴结病。左侧睾丸体积增大、坚硬、触痛不明显。检查发现贫血、白细胞减少、红细胞沉降率升高和高γ球蛋白血症。腹部超声显示主动脉旁、主动脉前、腔静脉前和双侧盆腔区域有多个增大的坏死性淋巴结。腹股沟淋巴结的细针抽吸细胞学（FNAC）未发现抗酸杆菌（AFB）。然而，切除活检显示淋巴组织，弥漫性增生的成熟浆细胞使结构消失，提示为多中心 Castleman 病的浆细胞变异型。由于怀疑睾丸肿瘤性增大，患者接受了双侧睾丸切除术，组织病理学显示血肿，睾丸萎缩，Castleman 病的浆细胞变异型继发性累及睾丸实质。
