Post direct acting anti-viral agents associated primary hepatic Castleman's disease: A case report
| Autor: | Nermine A. Ehsan, Dina Sweed, Mai Shalan, Thanaa El A Helal, Yahya A Fayed, Asmaa Mosbeh, Heba Abdelhalim, Dina S El-Azab, Shimaa Kilany |
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| Rok vydání: | 2020 |
| Předmět: |
Pathology
medicine.medical_specialty Imaging Lesion 03 medical and health sciences 0302 clinical medicine Case report Medicine Pathological Radiologic Finding Hyaline business.industry Mantle zone Germinal center Castleman's disease DAAs General Medicine medicine.disease 030220 oncology & carcinogenesis Hepatocellular carcinoma 030211 gastroenterology & hepatology Surgery Lymph medicine.symptom business |
| Zdroj: | Annals of Medicine and Surgery |
| ISSN: | 2049-0801 |
| Popis: | Introduction Castleman's disease (CD) is a primary lymphoproliferative disorder of the lymph nodes with rare extra-nodal primary affection. Presentation of case: Here we present a case of primary hepatic CD associated with hepatocellular carcinoma (HCC). Discussion: Sixty-two years old, male received direct-acting antiviral agents (DAAs) for HCV infection. Follow up revealed sustained virologic response; however, three hepatic focal lesions were accidently discovered. Triphasic CT confirmed the HCC nature of two masses while the other mass remained undiagnosed. Surgical intervention was the treatment of choice, and pathological examination showed a fairly circumscribed mass formed of angiolymphoid hyperplasia displayed atrophic germinal center, expanded mantle zone, and variable hyalinization. The radiological evaluation of lymph nodes was unremarkable. The patient is 40 months alive after resection, with no further management advised. Conclusion: The immune-modulatory effect of DAAs may induce hepatic CD development in a cirrhotic patient, necessitating further studies. A new radiologic finding was observed in the present case in the form of vessels traversing through the lesion with no attenuation or occlusion. Pathology remains the gold standard in the diagnosis of CD. Highlights • Eighteen cases of primary hepatic Castleman's disease (CD) has been reported. • The association of post direct-acting anti-viral agents with the development of both hepatocellular carcinoma (HCC) and CD may have immune base. • A new radiologic finding of hepatic CD in the form of vessels traversing through the lesion with no attenuation or occlusion has been encountered in this case. • Pathology remains the gold standard in the diagnosis of CD. |
| Databáze: | OpenAIRE |
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