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.
Curciarello
J
J
Department of Internal Medicine D, Hospital General San Martin La Plata National University Medical School, Argentina.
Castelletto
R
R
Barbero
R
R
Belloni
P
P
Gelemur
M
M
Castelletto
E
E
Jmelnitzky
A
A
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*