Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8304
Peer-review started: February 7, 2022
First decision: April 10, 2022
Revised: April 11, 2022
Accepted: June 30, 2022
Article in press: June 30, 2022
Published online: August 16, 2022
Phosphoglyceride crystal deposition disease (PCDD) is a rare acquired disease in which phospholipid crystals deposit in bone and soft tissue long after surgery, trauma, or repeated injections.
A 60-year-old-woman was referred to our department because of multiple abdominal masses after open splenectomy for idiopathic thrombocytopenic purpura 29 years earlier. All the masses showed marked fluorodeoxyglucose (FDG) uptake on 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) and were strongly suspected to be malignant tumors. Surgical biopsies were performed, and the abdominal masses were found to be aligned vertically, three in a row, along the tissue layers cut in the patient’s previous surgery. Pathological finding of the specimens showed foreign body granuloma consisting of histiocytes and multinucleated giant cells accumulating around needle-like crystals. The crystals were confirmed as phosphoglyceride by Raman spectroscopy, and PCDD was diagnosed. To our knowledge, this is the first report of PCDD diagnosed by Raman spectroscopy.
We made a definitive diagnosis of PCDD in a patient with multiple tumors showing marked FDG uptake on 18F-FDG-PET by incisional biopsy and compo- sition analysis using Raman spectroscopy, a method that has not previously been reported for the diagnosis of PCDD.
Core Tip: Here, we report a case in which Raman spectroscopy proved useful for differential diagnosis of phosphoglyceride crystal deposition disease (PCDD) in a patient with multiple malignant abdominal masses showing extremely high uptake on 18F-fluorodeoxyglucose positron emission tomography, many years after undergoing open splenectomy. Initially, we strongly suspected the masses to be malignant. To rule out malignancy, we performed surgical biopsies and the pathological diagnosis was foreign body granulomas with crystal deposition. Raman spectroscopy led to the definitive diagnosis of PCCD. Raman spectroscopy is a simple and precise method for diagnosing PCCD.