Retroperitoneal inflammatory pseudotumor: A rare cause of prolonged fever

Abstract

Introduction: Inflammatory pseudotumor of lymph node is a rare case in the etiology of fever of unknown origin. It is a rare pathology whose nosological definition is still unclear. Observation: We report the observation of a 27-year-old man presented with a two-month history of debilitating recurrent fever and weight loss. The remainder of his physical examination was unremarkable; specifically, no lymphadenopathy or organomegaly was detected. Serum protein electrophoresis was normal and fluorescent antinuclear antibody was negative. Serologic tests of Brucella species, cytomegalovirus, Epstein–Barr virus, and HIV were also negative. Numerous blood cultures were negative. Computerized tomographic scans of the chest and abdomen demonstrated mild enlargement of the retroperitoneal and iliac lymph nodes. Because of the suspicion of lymphoma, he underwent exploratory laparotomy, numerous periaortic and mesenteric lymph nodes were enlarged, and five were excised. The histologic examination concluded to a pseudotumor of lymph node. Discussion: Inflammatory pseudotumor is a benign reactive disease and rarely involves lymph nodes. Inflammatory pseudotumor arising from the lymph node was firstly reported in 1988. Any of the major lymph node groups may be involved. A single node is usually involved but multiple nodes may be affected simultaneously. Inflammatory pseudotumor of lymph node is a rare pathology whose nosological definition is unclear. It should probably be considered as belonging to a category different from the inflammatory pseudotumor of other organs. The diagnosis presents itself in case of isolated adenopathy or prolonged fever and is based on an anatomopathology.