Castleman病临床病理分析

The report and clinical analysis of Castleman's disease

目的探讨Castleman病(Castleman's disease,CD)的临床特点、诊治及预后,为以后临床对该病的诊治提供资料。方法回顾性分析我院2006年8月至2017年7月收治的9例CD患者的临床特点、治疗及预后。结果 9例CD按临床分型:局灶型6例(66.7%),多中心型3例(33.3%);按病理类型分:透明血管型6例(66.7%),浆细胞型3例(33.3%)。9例均手术切除肿大淋巴结或取活检,并配合内科综合治疗,8例恢复良好,1例自动出院失访。结论 CD临床表现无特异性,术前诊断较困难,容易与其他疾病混淆,最终靠病检确诊;临床分型以局灶型较多见,病理分型中透明血管型多见;手术为主,部分可需要联合综合治疗。

Objective To investigate the clinical characteristics,diagnosis,treatment and prognosis of Castleman disease,and to provide some guidance for the diagnosis and treatment of the disease.Methods A retrospective study was conducted to analyze the clinical characteristics,treatment and prognosis of 9 cases of Castleman disease treated in our hospital from 2006 to 2017,and to analyze the related literature and research.Results 9 cases of Castleman disease were classified according to the clinical type： LCD was 6 cases（ 6/9,66. 7%）,manifested as mediastinal and cervical focal lymph nodes enlargement; MCD was 3 cases（ 3/9,33. 3%） showed multiple lymph node enlargement or with serous cavity effusion and decreased renal function; According to pathological type： HV was 6 cases（ 6/9,66. 7%）,PC was 3 cases（ 3/9,33. 3%）.All of 9 cases were treated with surgical resection of lymph nodes or biopsy,and they recovered well with comprehensive medical treatment.1 cases were discharged from hospital automatically and lost access.Conclusion Castleman disease was a rare lymphoproliferative disease.LCD was common,performanced for the local lymph node enlargement.HV was common in hyaline vascular type.Castleman disease was nonspecific.The enlarged lymph nodes can be removed by surgery,and the final diagnosis was confirmed by the pathological examination.Some patients recovered well after operation,and some patients can be alleviated with combining some comprehensive treatment.