Martino G, Stanzani G L, Cariati S, Elmore U, Tumino G, Zelli G P
Università degli Studi di Roma La sapienza, Cattedra di Chirurgia Geriatrica I.
Ann Ital Chir. 1995 Jul-Aug;66(4):521-9.
An unusual case is reported of the rare Castleman's disease localized in the retroperitoneal area in an elderly asymptomatic patient. A similar benign lymphoadenopathy of unknown etiology is generally found in the mediastinum and interests just one lymph-node that results abnormally hyperplastic. Histologically, most cases are of the hyaline-vascular type and much more rarely of the plasmacell variant. After a careful review of the literature the anatomical, pathological and clinical characteristics, the main etiopathogenetics hypotheses and diagnostic criteria are explained. The particular size of the neoformation is emphasized and also the impossibility to reach a correct preoperatory diagnosis owing to a suspect kidney parenchyma infiltration observed by RM. Also the intraoperatory report seemed to confirm the diagnostic hypothesis of a malign neoplasm infiltrating the lower pole of the kidney and which necessitated the total ablation of the retroperitoneal mass and left kidney. We concluded that the case which we have observed (the 32nd in world literature dealing with the retroperitoneal space) is not really comparable to those previously described by other authors. In fact the histopathological picture presents a series of ialino-vascular and plasmacell aspects which make any hypothesis of etiopathogenetic uncertain.
本文报道了一例罕见病例,一名老年无症状患者的Castleman病局限于腹膜后区域。类似的病因不明的良性淋巴结病通常见于纵隔,且仅累及一个异常增生的淋巴结。组织学上,大多数病例为透明血管型,浆细胞变异型则更为罕见。在仔细查阅文献后,对其解剖学、病理学和临床特征、主要病因学假说及诊断标准进行了解释。强调了新生物的特殊大小,以及由于磁共振成像观察到可疑的肾实质浸润而无法在术前做出正确诊断的情况。术中报告似乎也证实了恶性肿瘤浸润肾下极的诊断假说,这使得有必要将腹膜后肿块和左肾全部切除。我们得出结论,我们观察到的病例(世界文献中第32例涉及腹膜后间隙的病例)与其他作者先前描述的病例并不真正可比。事实上,组织病理学表现呈现出一系列透明血管和浆细胞特征,这使得任何病因学假说都不确定。