Hepatic sinusoidal dilatation associated to giant lymph node hyperplasia (Castleman's): a new case in a patient with periorbital xanthelasmas and history of celiac disease.
We present a new case of hepatic sinusoidal dilatation associated to giant lymph node hyperplasia or Castleman's disease in a 23-year-old patient with xanthelasmas and history of celiac disease. He presented with weight loss, hepatomegaly, periorbital xanthomas, anemia, accelerated erythrosedimentation rate, hypoalbuminemia, hypergammaglobulinemia at the expense of immunoglobulin G (IgG), high titers of autoantibodies, and increase of serum alkaline phosphatase and gamma glutamyl transpeptidase activity. A liver biopsy showed sinusoidal dilatation. Fifteen months later, a computed axial tomography showed a retroperitoneal tumor that turned out to be a giant lymph node hyperplasia. After resection of the tumor all clinic and biochemical manifestations had faded, suggesting an association between xanthelasmas, Castleman's disease, sinusoidal dilatation, and celiac disease. A humoral factor produced by the lymph tumor of the patient may have been responsible for the immunologic alterations he presented.
Department of Internal Medicine D, Hospital General San Martin La Plata National University Medical School, Argentina.
J
J
Curciarello
R
R
Castelletto
R
R
Barbero
P
P
Belloni
M
M
Gelemur
E
E
Castelletto
A
A
Jmelnitzky
D000328:Adult; D005871:Castleman Disease / Q000150:complications* / Q000473:pathology / Q000601:surgery; D002446:Celiac Disease / Q000150:complications*; D004108:Dilatation, Pathologic; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D009916:Orbital Diseases / Q000150:complications*; D014973:Xanthomatosis / Q000150:complications*