前纵隔结外Rosai-Dorfman病1例报告  

Extranodal Rosai-Dorfman Disease of Anterior Mediastinum:A Case Report

作　　者：刘静[1] 万影 蒲华霞 彭礼清[1] LIU Jing;WAN Ying;PU Hua-xia;PENG Li-qing(Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Pathology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院放射科,成都610041 [2]四川大学华西医院病理科,成都610041

出　　处：《四川大学学报（医学版）》2021年第6期1044-1046,共3页Journal of Sichuan University(Medical Sciences)

摘　　要：患者,女,28岁,因"发现前纵隔占位4年"入院。胸部增强CT扫描提示前纵隔软组织肿块伴轻度均匀强化,大小约7.1 cm×3.8 cm,考虑为胸腺瘤。于全麻下行"前纵隔肿块切除术"。术后病理示:纤维组织增生及玻变的背景上可见泡沫样组织细胞呈灶性分布,伴淋巴组织增生及浆细胞浸润,并见淋巴细胞、浆细胞"伸入"组织细胞现象。免疫组化染色示:S100蛋白(+)、CD68抗体(+)、CD163抗体(+)、免疫球蛋白G4(Ig G4)(+)及CD1a抗体(-)。最终诊断为结外Rosai-Dorfman病(RDD)。在3年随访期内,该患者未出现相关临床症状,复查CT未提示有复发征象。此病在影像学上需要与其他前纵隔肿块鉴别,如胸腺瘤、淋巴瘤及畸胎瘤等。A 28-year-old female patient was referred to and admitted in our hospital for presence of anterior mediastinal mass for 4 years.Enchanced chest computed tomography(CT) revealed an anterior mediastinal mass of softtissue density measuring 7.1 cm×3.8 cm with slight homogeneous enhancement after intravenous administration of contrast agent.The mass was clinically considered a thymoma.Then,surgical excision of anterior mediastinal mass was performed under general anesthesia.Postoperative histopathology revealed that there were foamy histiocyte clusters on the background of fibrous tissue hyperplasia and hyaline,with lymphoid hyperplasia,infiltration of plasma cells,and the presence of emperipolesis of lymphocytes and plasma cells in the tissue cells.Immunohistochemistry showed S100 protein(+),cluster of differentiation(CD) 68(+),CD163(+),immunoglobulin G4(+),and CD1 a(-).Eventually,confirmed diagnosis of extranodal Rosai-Dorfman disease was made.The patient showed no clinical symptoms and no recurrence was found on CT images over the 3-year followup.In clinical practice,this disease should be differentiated from other anterior mediastinal masses such as thymoma,lymphoma,and teratoma.

关 键 词：ROSAI-DORFMAN病 纵隔 体层摄影术 

分 类 号：R655.5[医药卫生—外科学]