Castleman病临床和病理分析

Clinical and pathological study on Castleman disease

目的:了解Castleman病临床特点及组织病理学改变,提高对该病的认识。方法:回顾性分析16例Castleman病的临床特点、组织病理学改变及临床诊断治疗。结果:16例患者男性居多,中位年龄42岁,以多中心型多见,表现为多处淋巴结肿大,单一部位病变即局灶型相对少见。系统性症状多见于多中心型,有肾脏、肝脏及周围神经累及。淋巴结病理以透明血管型多见,浆细胞型及混合型次之。结论:Castleman病具有典型的淋巴结组织病理学改变,但临床表现无特征性,易与淋巴瘤等病变相混淆,局灶型手术切除预后较好,多中心型预后则与起病时系统累及情况有关。

Objective：To understand the clinical features and histopathology of Castleman disease（CD）so as to better recognize the disease.Method：The clinical features,histopathology,diagnosis and therapy of sixteen patients with CD were retrieved and analyzed.Result：Sixteen patients were male-dominated,with a median age of 42 years old.Multicentric Castleman＇s disease（MCD）was the majority,which showed widespread lymphadenopathy.Solitary lymphadenopathy that is unicentric Castleman＇s disease（UCD）was relatively uncommon.Systemic symptoms were more common in MCD,accompaned with kidney,liver and peripheral nerve injured.Pathologically,hyaline vascular type was the majority,plasma cell type and mixed type followed by.Conclusion：The lymph nodes of CD show typical histopathological features.Since there is no characteristic clinical manifestation,it tends to be misdiagnosed as lymphoma.UCD is curable by surgical resection of tumor.The prognosis of patients with MCD was associated with systemic damage when the disease was diagnosed.