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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
Idiopathic multicentric Castleman disease
Vipul Chaudhari1, Simran Jatin Thakkar2, Namita Padwal2
1Department of Gastroenterology, Lokamanya Tilak Municipal Medical College, Mumbai, Maharashtra, India.
Abstract:
An elderly man presented with fever and chills for six months, associated with loss of appetite and weight loss, bilateral edema, and non-tender inguinal lymphadenopathy. The left-sided testicle was bulky, firm, and non-tender. Investigations revealed anemia, leukopenia, elevated erythrocyte sedimentation rate, and hypergammaglobulinemia. Ultrasound of the abdomen revealed multiple enlarged necrotic lymph nodes in the periaortic, preaortic, precaval, and bilateral pelvic regions. Fine-needle aspiration cytology (FNAC) of the inguinal nodes showed no acid-fast bacilli (AFB). However, excision biopsy revealed lymphoid tissue with effacement of architecture by diffuse proliferation of mature plasma cells, suggestive of the plasma cell variant of multicentric Castleman disease. Due to suspicion of neoplastic testicular enlargement, the patient underwent bilateral orchidectomy, and histopathology showed hematocele with atrophy of the testis and secondary involvement of the testicular parenchyma by plasma cell variant of Castleman disease.
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