Castleman病的CT表现与相关性病理分析

CT features of Castleman disease and pathological analysis

目的探讨Castleman病的CT特点与病理类型的关系。方法回顾性分析7例发生于颈部、纵隔、腹部及盆腔,经病理证实为Castleman病的临床、病理表现及影像学资料。6例接受CT平扫及增强扫描。临床上分为局限型(6例)和多中心型(1例)。结果局限型6例,均为透明血管型,CT平扫表现为单个类圆形或椭圆形软组织肿块,1例可见点状及分支状钙化灶,1例肿块内见低密度囊变区,2例病灶周围筋膜增厚;增强后病灶强化程度与大血管相似。病理切片可见淋巴滤泡增生伴大量小血管增生。多中心型1例,为浆细胞型。CT表现为多发淋巴结肿大。病理切片见滤泡间浆细胞浸润。结论 Castleman病的影像学表现与病理类型密切相关。CT特征性表现有助于诊断及鉴别诊断。

Objective To analyze the CT features of Castleman disease and correlation with pathology. Methods Unenhanced （7） and enhanced （6） CT images of 7 pathologically confirmed cases of Castleman disease were reviewed. The disease was classified as localized （6） or disseminated （1） clinically as well as hyaline vascular or plasma cell type histologically. Results All 6 clinically localized cases were of the hyaline vascular type. CT showed single, round or elliptical masses with intra-tumoral calcification （1 patient）, hypodense cystic areas （1） and fascial thickening around the masses （2）. All of the masses enhanced with contrast similar to that of large vessels. Numerous hyperplastic lymph follicles and vascular proliferation were detected histologically. One patient with disseminated disease was classified as plasma cell type. CT showed multi-centric enlarged lymph nodes. Histological analysis revealed marked plasma ceU proliferation. Conclusion CT findings of Castleman disease closely correlate with pathology and can aid the diagnosis.