结肠多发性罗赛-多夫曼病病灶:病例报告。

IF 0.7 Q4 SURGERY Surgical Case Reports Pub Date : 2024-07-19 DOI:10.1186/s40792-024-01973-z
Eri Kisu, Masatsugu Hiraki, Keiichiro Okuyama, Sachiko Maeda, Shin Takesue, Kana Kusaba, Keita Kai, Tatsuya Manabe, Hirokazu Noshiro
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摘要

背景:罗赛-多夫曼病(RDD)是一种不常见的增殖性组织细胞疾病,累及淋巴结和多个器官。43%的RDD病例起源于结肠外部位;然而,RDD很少起源于结肠:一名 75 岁的男性因在肺癌治疗后接受计算机断层扫描(CT)监测时意外发现腹内肿块而入院。增强 CT 显示,盲肠至阑尾(直径 40 毫米)和乙状结肠周围(直径 24 毫米)有两个肿块病变。正电子发射断层扫描(PET)-CT 显示出明显的氟脱氧葡萄糖摄取。腔内内镜检查未发现明确的粘膜异常。这些发现提示存在恶性肿瘤,包括胃肠道间质瘤、肺癌转移和恶性淋巴瘤。为获得明确诊断,计划进行探查性腹腔镜检查和/或肿瘤切除术。根据腹腔镜检查结果,同时进行了回盲部切除术和乙状结肠切除术,以切除肿瘤。术后组织病理学检查显示,多发性 RDD 起源于盲肠结肠系膜侧和乙状结肠。患者没有接受任何辅助治疗。术后一年未见复发:结论:源自结肠的 RDD 极其罕见。结论:起源于结肠的 RDD 极其罕见,有时需要进行肿瘤切除或器官切除才能获得 RDD 的明确诊断,微创手术很有帮助。
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Multiple foci of Rosai-Dorfman disease in colon: a case report.

Background: Rosai-Dorfman disease (RDD) is an uncommon proliferative histiocytic disorder involving lymph nodes and various organs. Forty-three percent of RDD cases originate from extranodal sites; however, RDD rarely arises from the colon.

Case presentation: A 75-year-old man was admitted to our hospital because of intra-abdominal masses that were incidentally detected during surveillance by computed tomography (CT) after treatment for lung cancer. Enhanced CT showed two mass lesions located in the cecum to the appendix (diameter, 40 mm) and around the sigmoid colon (diameter, 24 mm). Positron emission tomography (PET)-CT revealed an apparent uptake of fluorodeoxyglucose. Intraluminal endoscopy did not reveal definite mucosal abnormalities. These findings suggest the presence of malignant neoplasms including gastrointestinal stromal tumors, lung cancer metastasis, and malignant lymphoma. Exploratory laparoscopy and/or tumor excision were planned to obtain a definitive diagnosis. Based on laparoscopic findings, ileocecal resection and sigmoidectomy were simultaneously performed to excise the tumors. Postoperative histopathological examination revealed multiple RDD originating from the mesocolon side of the cecum and the sigmoid colon. The patient did not receive any adjuvant therapy. No recurrence was observed one year after surgery.

Conclusion: RDD originating from the colon is extremely rare. Tumor extirpation or organ resection is sometimes required to obtain a definitive diagnosis of RDD, and minimally invasive surgery is helpful.

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