Kastlemanova bolest udružena sa mešanim poremećajem vezivnog tkiva i cerebralnom ishemijom i vaskulitisom: redak slučaj i dijagnostički izazov za infektologa

  • Lidija Popović Dragonjić Clinical Center Niš, Clinic for Infectious Diseases, Niš, Serbia
  • Maja Jovanović Clinical Center Niš, Clinic for Infectious Diseases, Niš, Serbia
  • Miodrag Vrbić Clinical Center Niš, Clinic for Infectious Diseases, Niš, Serbia
  • Maja Stanojević University of Belgrade, Department of Microbiology and Immunology, Belgrade, Serbia
  • Miljan Krstić University of Niš, Faculty of Medicine, Department of Pathology, Niš, Serbia
  • Aleksandar Tasić Clinical Center Niš, Center for Radiology, Niš, Serbia
  • Nikola Živković University of Niš, Faculty of Medicine, Department of Pathology, Niš, Serbia
DOI: https://doi.org/10.2298/VSP180525144P
Ključne reči: kastlemanova bolest, dijagnostičke tehnike i procedure, dijagnoza diferencijalna, neurološke manifestacije, histologija

Sažetak


Uvod. Kastlemanova bolest (KB) ili angiofolikularna hiperplazija limfnih čvorova je redak patohistološki proces koji se karakteriše ne-neoplastičnom reaktivnom proliferacijom limfnog tkiva. S obzirom da imitira kliničke i laboratorijske znake infekcije, može predstavljati značajan dijagnostički problem za infektologa. Prikaz bolesnika. Predstavljamo tok bolesti tridesetdevetogodišnjeg muškarca kod koga je u početku bila postavljena klinička sumnja na infekciju centralnog nervnog sistema (CNS), koja je najviše podsećala na neurotuberkulozu. Među ostalim mogućim dijagnozama našli su se i malignitet sa metastazama u kostima i limfom. U daljem toku, kod bolesnika je histološkom analizom limfnog čvora utvrđena KB, što je bilo presudno u odbacivanju sumnje na malignitet i tuberkulozu. Dodatnim analizama je kod bolesnika utvrđena mešovita bolest vezivnog tkiva (MBVT). Magnetnom rezonancom otkriven je vaskulitis mezencefalona i talamusa. Zaključak. Kastlemanova bolest sa zahvatanjem CNS-a veoma je retka, kao i KB udružena sa MBVT, što zajedno ovaj slučaj čini još jedinstvenijim. Ovim prikazom slučaja naglašava se važnost definitivne histološke dijagnoze kod bolesnika sa limfadenopatijom i pridruženim sistemskim manifestacijama i potreba za dodatnim imunološkim i radiološkim analizama.

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Objavljeno
2021/04/08
Broj časopisa
Vol. 77 Br. 8 (2020): Vojnosanit pregl
Rubrika
Prikaz bolesnika