儿童少见颈部假性瘤——Kimura病和Castleman病

Uncommon pseudotumors in the neck site in children: Kimura’s disease and Castleman’s disease

目的回顾性分析儿童少见颈部假性肿物Kimura病和Castleman病的临床与病理特点。方法自1994年1月至2004年12月共作了143例儿童颈部淋巴结活检，其中Kimura病3例，Castleman病5例。平均年龄7．86岁，均作了全切除手术，复习病理（HE染色）特点及术后随诊，主要视颈部肿物复发情况。结果3例Kimura病病理检查见肿物组织内小血管扩张，且伴淋巴样细胞增生浸润，在外周血中嗜酸性细胞增多（〉5％）。5例Castleman病为血管滤泡增生，手术后随访了3～14年，平均5．5年。二病各复发1例，经再切除后未见复发。结论Kimura和Castleman病可以在儿童期颈部以假性瘤表现，诊断主要依靠病理学，治疗以外科手术肿物全切除为主，有复发情况。

Objective To analyze the clinical and pathological patterns of uncommon pseudotumors in the neck site in children. Methods Biopsy was performed in 143 cases with lymphocytic nodules in the neck from January 1994 to December 2004. Three of them were Kimura＇s disease and 5 of them were Castleman＇s disease. All patients underwent total mass resection and pathological examination. Results Total removal of mass was successfully done in all patients. Upon pathological findings, Kimura＇s disease showed angiolymphoid hyperplasia with eosinophilia in mass tissue, and Castleman＇ s disease showed a benign lymphoproliferative disease as homogeneously enlarged lymph nodes. All patients were followed up from 3 to 14 years （mean 5. 5 years）, 2 cases （25%） suffered from the recurrence of mass and underwent surgical resection again. Conclusions Kimurecs disease and Castleman＇s disease are two uncommon pseudotumors in the neck site in children. It should pay attention to the recurrence of these two diseases.