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Thoracic Paraspinal Castleman Disease in a Young Mexican-American Man with Postcoital Hematuria.
Foster, Chase H; Elahi, Cyrus; Cheney, Stephen; Trier, Todd; Torabi, Alireza; Manglik, Niti.
Afiliação
  • Foster CH; Department of Neurological Surgery, George Washington University Hospital, Washington DC, USA.
  • Elahi C; Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA. Electronic address: cyrus.elahi@duke.edu.
  • Cheney S; Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas, USA.
  • Trier T; Department of Neurosurgery, University Medical Center of El Paso, El Paso, Texas, USA.
  • Torabi A; Department of Pathology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA.
  • Manglik N; Department of Pathology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA.
World Neurosurg ; 120: 36-42, 2018 Dec.
Article em En | MEDLINE | ID: mdl-30165219
BACKGROUND: Castleman disease (CD) is an uncommon disorder of deregulated lymphoproliferation with unicentric (UCD) and multicentric forms based on extent of nodal involvement. Gross resection with histopathologic analysis remains the gold standard for diagnosis of UCD and is curative in most cases. Symptomatic paraspinal UCD is a rare presentation with potentially dangerous complications, and its tendency to mimic more common spinal tumors presents a significant diagnostic challenge. CASE PRESENTATION: A 25-year-old Hispanic man with no past medical history was evaluated for a known left-sided paraspinal mass that was incidentally discovered during an emergency department work-up for hematuria. Computed tomography on initial presentation revealed a 5.3 cm × 3.3 cm × 4.8 cm heterogeneously enhancing left paraspinal mass adjacent to the T11 vertebral body with tonguelike extension into the T11-T12 neural foramen. Although he remained neurologically intact throughout most of the diagnostic work-up, an inconclusive biopsy, worsening hematuria, and late-onset radiculopathy with severe back pain prompted surgical intervention. Microscopic histomorphology was consistent with CD. He continued to have intermittent hematuria and dysuria postoperatively, but repeat computed tomography at 7 months confirmed no recurrence of the mass. CONCLUSIONS: Compared with previous reports, our case of postcoital hematuria and radiculopathy accompanying a paraspinal thoracic mass in a young Mexican-American man is a unique presentation. Awareness and early consideration of UCD in the work-up of a paraspinal mass may spare affected patients adverse and dangerous sequelae, such as spinal cord compression and excessive intraoperative hemorrhage.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hiperplasia do Linfonodo Gigante / Hematúria Tipo de estudo: Diagnostic_studies Limite: Adult / Humans / Male País/Região como assunto: Mexico Idioma: En Revista: World Neurosurg Assunto da revista: NEUROCIRURGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hiperplasia do Linfonodo Gigante / Hematúria Tipo de estudo: Diagnostic_studies Limite: Adult / Humans / Male País/Região como assunto: Mexico Idioma: En Revista: World Neurosurg Assunto da revista: NEUROCIRURGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos