An Elusive Diagnosis of Castleman Disease

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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.

难以确诊的卡斯特曼病
我们为您介绍一例 41 岁男性病例,他患有前纵隔肿块,并伴有呼吸困难、胸腔积液、心包积液、肾功能不全和全血细胞减少等一系列临床症状。在几项实验室检查和一份无诊断意义的手术活检标本均未得出结论后,第二次手术活检标本确定患者的病症为卡斯特曼病伴发TAFRO(血小板减少、贫血、发热、网状纤维骨髓纤维化、器官肿大)综合征。本病例强调了获取大量组织活检样本、间隔随访和认识认知偏差的重要性。
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