局灶性Castleman病2例报告并文献复习

Local cast leman's disease:a report of 2 cases with literature review

目的 Castleman病(Castleman’s disease,CD)又称血管滤泡性淋巴组织增生或巨大淋巴结增生,是一种少见的原因未明的反应性淋巴结病。本研究报告2例局灶性Castleman病(local Castleman’s disease,LCD),结合复习相关文献,以提高对LCD的诊治水平。方法回顾性分析泰安市中心医院从1994年至2009年收治的2例LCD患者临床资料。结果 1例患者有轻度局部压迫症状,1例患者无明显临床症状,呈单个淋巴结增生,淋巴结最大径4～4.5 cm,其中1例位于颈部,1例位于腹膜后。经术后病理确诊,均为透明血管型。1例患者出现血尿(++),尿蛋白(+),17-OH1、7-KS类固醇增高。2例患者均行肿物切除术,术后无肿瘤复发。结论 LCD主要表现为单一部位的淋巴结肿大,以透明血管型为主,多无临床症状和实验室检查异常结果。CT检查对诊断有一定帮助,但确诊仍靠病理。手术切除疗效好,术后可长期生存。

Objective： Castleman＇s disease（CD）,also named angiofollicular lymph node hyperplasia or giant lymph node hyper plasia,is an uncommon reactive lymphadenopathy with unknown causes.This study was to report clinical features and therapeutic outcomes of 2 cases of local Cast leman＇s disease（LCD）,to review literatures so as to improve the diagnosis and treatment of CD.Methods： Clinical data of 2 LCD patients treated in Taian city Central hospital between 1990 to 2009 were reviewed.Results： A single lymph node was observed in a single location.The longest diameters of involved lymph nodes ranged from 4 to 4.5 cm.The lesions were located in the neck and retroperitoneal.Both of the 2 cases were hyaline vascular type and they were confirmed pathologically.One patient had high 17-OH and 17-KS steroid.The other had normal laboratory results.All patients underwent complete surgical resection.Conclusion： LCD patients of lymphadenectas are mainly in a single location,having no clinical symptoms and normal laboratory results,with a majority being hyaline vascular type.Although CT is helpful for the diagnosis of LCD,the final diagnosis depends on pathologic examination.LCD patients can live long without recurrence after complete surgical resection of the tumor.