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卡斯特曼病的疑难诊断

An Elusive Diagnosis of Castleman Disease.

作者信息

Rifai Yasmine, Bhagat Rohun, Murthy Sudish, Bribriesco Alejandro

机构信息

Hackensack Meridian School of Medicine, Nutley, New Jersey.

Department of Thoracic & Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.

出版信息

Ann Thorac Surg Short Rep. 2024 Mar 27;2(3):548-551. doi: 10.1016/j.atssr.2024.02.018. eCollection 2024 Sep.

DOI:10.1016/j.atssr.2024.02.018
PMID:39790424
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11708629/
Abstract

We present the case of a 41-year-old man with an anterior mediastinal mass and constellation of clinical symptoms, including dyspnea, pleural effusions, pericardial effusions, renal insufficiency, and pancytopenia. After inconclusive results on several laboratory tests and a nondiagnostic surgical biopsy specimen, a specimen from a second surgical biopsy identified the patient's condition as Castleman disease associated with TAFRO (thrombocytopenia, anasarca, fevers, reticulin myelofibrosis, organomegaly) syndrome. This case highlights the importance of obtaining large tissue biopsy samples, interval follow-up, and acknowledging cognitive biases.

摘要

我们报告了一例41岁男性患者，其患有前纵隔肿块并伴有一系列临床症状，包括呼吸困难、胸腔积液、心包积液、肾功能不全和全血细胞减少。在多项实验室检查结果不明确且手术活检标本未能确诊后，第二次手术活检的标本确定该患者的病情为与TAFRO（血小板减少、全身水肿、发热、网状纤维骨髓纤维化、器官肿大）综合征相关的Castleman病。该病例突出了获取大组织活检样本、定期随访以及认识认知偏差的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0096/11708629/583bafbf589f/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0096/11708629/b32e14289227/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0096/11708629/55d014d4b5ba/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0096/11708629/583bafbf589f/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0096/11708629/b32e14289227/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0096/11708629/55d014d4b5ba/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0096/11708629/583bafbf589f/gr3.jpg

相似文献

1
An Elusive Diagnosis of Castleman Disease.卡斯特曼病的疑难诊断
Ann Thorac Surg Short Rep. 2024 Mar 27;2(3):548-551. doi: 10.1016/j.atssr.2024.02.018. eCollection 2024 Sep.
2
The first case of thrombocytopenia, anasarca, fever, renal impairment or reticulin fibrosis, and organomegaly (TAFRO) syndrome with unilateral adrenal necrosis: a case report.首例伴有单侧肾上腺坏死的血小板减少、全身水肿、发热、肾功能损害或网状纤维增生及器官肿大（TAFRO）综合征：病例报告
J Med Case Rep. 2018 Oct 8;12(1):295. doi: 10.1186/s13256-018-1814-9.
3
Thrombocytopenia, Anasarca, Fever, Reticulin Fibrosis/Renal Failure, and Organomegaly (TAFRO) Syndrome with Bilateral Adrenal Hemorrhage in Two Caucasian Patients.两名白种人患者出现伴有双侧肾上腺出血的血小板减少、全身性水肿、发热、网状纤维变性/肾衰竭和器官肿大（TAFRO）综合征
Am J Case Rep. 2020 Apr 6;21:e919536. doi: 10.12659/AJCR.919536.
4
Validated international definition of the thrombocytopenia, anasarca, fever, reticulin fibrosis, renal insufficiency, and organomegaly clinical subtype (TAFRO) of idiopathic multicentric Castleman disease.特发性多中心 Castleman 病伴血小板减少、浮肿、发热、网状纤维纤维化、肾功能不全和器官肿大（TAFRO）临床亚型的验证性国际定义。
Am J Hematol. 2021 Oct 1;96(10):1241-1252. doi: 10.1002/ajh.26292. Epub 2021 Jul 28.
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A severe case of thrombocytopenia, anasarca, fever, renal insufficiency or reticulin fibrosis, and organomegaly syndrome with myocardial and skeletal muscle calcification despite hypocalcemia: a case report.一例严重血小板减少、全身性水肿、发热、肾功能不全或网状纤维组织增生以及尽管存在低钙血症但伴有心肌和骨骼肌钙化的器官肿大综合征：病例报告
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Kidney biopsy findings in two patients with TAFRO syndrome: case presentations and review of the literature.两名 TAFRO 综合征患者的肾活检结果：病例报告及文献复习。
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Hepatic Campylobacter jejuni infection in patients with Castleman-Kojima disease (idiopathic multicentric Castleman disease with thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly (TAFRO) syndrome).患者出现肝弯曲杆菌空肠亚种感染（特发性多中心 Castleman 病伴血小板减少、全身性水肿、发热、网状纤维纤维化和器官肿大（TAFRO）综合征）。
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TAFRO Syndrome with an Anterior Mediastinal Mass and Lethal Autoantibody-Mediated Thrombocytopenia: An Autopsy Case Report.TAFRO 综合征伴前纵隔肿块和致命性抗体介导性血小板减少症：尸检病例报告。
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本文引用的文献

1
TAFRO syndrome: A disease that known is half cured.TAFRO 综合征：一知半解，病难治。
Hematol Oncol. 2023 Aug;41(3):310-322. doi: 10.1002/hon.3075. Epub 2022 Oct 3.
2
2019 Updated diagnostic criteria and disease severity classification for TAFRO syndrome.2019年TAFRO综合征更新的诊断标准和疾病严重程度分类。
Int J Hematol. 2020 Jan;111(1):155-158. doi: 10.1007/s12185-019-02780-1. Epub 2019 Nov 28.
3
TAFRO syndrome: New subtype of idiopathic multicentric Castleman disease.TAFRO综合征：特发性多中心Castleman病的新亚型。
Bosn J Basic Med Sci. 2017 May 20;17(2):81-84. doi: 10.17305/bjbms.2017.1930.
4
Proposed diagnostic criteria, disease severity classification and treatment strategy for TAFRO syndrome, 2015 version.TAFRO综合征的拟诊标准、疾病严重程度分类及治疗策略，2015年版
Int J Hematol. 2016 Jun;103(6):686-92. doi: 10.1007/s12185-016-1979-1. Epub 2016 Mar 18.
5
Anterior mediastinal masses: A study of 50 cases by fine needle aspiration cytology and core needle biopsy as a diagnostic procedure.前纵隔肿物：一项通过细针穿刺细胞学检查和粗针活检作为诊断方法对50例病例的研究。
South Asian J Cancer. 2013 Jan;2(1):7-13. doi: 10.4103/2278-330X.105872.
6
A diagnostic approach to the mediastinal masses.纵隔肿块的诊断方法。
Insights Imaging. 2013 Feb;4(1):29-52. doi: 10.1007/s13244-012-0201-0. Epub 2012 Dec 6.