背景:Castleman病(CD)是一种病因不明的罕见多克隆淋巴增生性疾病,通常在纵隔发展。它也可以发生在宫颈,腹膜后和腋窝区。局限性胰腺CD相当罕见[1]。
方法:作者在此介绍了一例34岁的女性,该女性在症状性胆石症评估中被诊断出。在评估过程中,腹部超声检查发现胰头有肿瘤,这导致肝外胆管扩张。腹部磁共振成像(MRI)证实了这一发现。随后,病人做了剖腹手术,在胰腺头部发现包囊肿瘤,边缘明确。决定切除肿瘤。组织病理学和免疫组织化学建立CD,透明血管变异。
结论:本文的作者还进行了有关胰腺CD的文献综述,在本文撰写之前,只有33个案例,我们随后对所有病例进行了回顾性分析。在一个图像不典型的病人身上,术前诊断CD可能会有好处,通过在图像引导活检中使用免疫组织化学分析。因此,避免不必要的手术和手术。
结论:胰腺局部CD是一种非常罕见的疾病,预后良好,但它可以模仿许多常见疾病,如胃肠道间质瘤(GIST),胰腺神经内分泌肿瘤或胰腺腺癌。
BACKGROUND: Castleman disease (CD) is a rare polyclonal lymphoproliferative disorder of unknown etiology, which usually develops in the mediastinum. It can also occur in the cervical, retroperitoneal and axillary regions. Localized pancreatic CD is quite rare [1].
METHODS: The authors herein present a case of a 34 years old female that was diagnosed during a symptomatic cholelithiasis evaluation. During the evaluation, an abdominal ultrasonography revealed a tumor at the head of the pancreas, which went on to generate a dilatation of the extrahepatic bile ducts. This finding was confirmed by abdominal magnetic resonance imaging (MRI). Subsequently, the patient underwent a laparotomy, where a capsulated tumor was found at the head of the pancreas with well-defined margins. The decision was made for tumor excision. The histopathology and immunohistochemistry established CD, hyaline vascular variation.
CONCLUSIONS: The authors of the present paper also performed a literature
review concerning Pancreatic CD, where there were found only 33 cases until the time of the writing of this paper, and we have subsequently carried out a retrospective analysis of all cases. In a patient with atypical images, there might be a benefit from a preoperative diagnosis of CD, by using immunohistochemistry analysis in an image guided biopsy. Thus, avoiding unnecessary procedures and surgeries.
CONCLUSIONS: Localized pancreatic CD is a very rare condition with good prognosis, but it can mimic many common diseases, such as gastrointestinal stromal tumor (GIST), pancreatic neuroendocrine tumor or pancreatic adenocarcinoma.