Izutsu K, Usuki K, Inoue K, Endo M, Iki S, Matsuya S, Urabe A
Division of Hematology, Kanto Teishin Hopital.
Rinsho Ketsueki. 1998 Mar;39(3):210-5.
A 62 year-old man had fever, splenomegaly, systemic lymphadenopathy and palpable petechiae. Laboratory studies showed leukocytosis (10,200/microliters) with plasma cells (23%) and polyclonal gammopathy. Southern blot analysis of peripheral blood mononuclear cells showed no rearrangement of immunoglobulin genes, indicating polyclonal plasmacytosis in peripheral blood. A diagnosis of Castleman's disease was made by the cervical lymph node biopsy, which showed onion-skin structures in the germinal centers and plasmacytosis in the interfollicular region. A skin biopsy of the purpura lesion disclosed leukocytoclastic vasculitis. This is an unusual case of Castleman's disease presenting plasmacytosis in peripheral blood and leukocytoclastic vasculitis.
一名62岁男性出现发热、脾肿大、全身淋巴结病及可触及的瘀点。实验室检查显示白细胞增多（10,200/微升），伴有浆细胞（23%）及多克隆丙种球蛋白病。外周血单核细胞的Southern印迹分析显示免疫球蛋白基因无重排，提示外周血多克隆浆细胞增多。经颈部淋巴结活检诊断为Castleman病，活检显示生发中心有洋葱皮样结构，滤泡间区有浆细胞增多。紫癜皮损的皮肤活检显示白细胞破碎性血管炎。这是一例不寻常的Castleman病，表现为外周血浆细胞增多及白细胞破碎性血管炎。
