腹盆部Castleman病的诊治分析

Diagnosis and treatment of abdominal and pelvic Castleman's disease

目的探讨腹盆部Castleman病的临床特点和治疗方法。方法回顾性分析2007年1月至2017年10月郑州大学第一附属医院经病理确诊的51例腹盆部Castleman病患者的临床病理资料。根据临床分型分为两组,局灶型Castleman病组(42例)和多中心型Castleman病组(9例)。结果局灶型42例患者中32例无症状(76%),其他伴腹部、腰背部疼痛、腹胀。病理以透明血管型为主(93%),41例通过手术治疗治愈。多中心型表现为全身多发浅表及深部淋巴结肿大,伴贫血、发热、体重减轻、呼吸困难。实验室检查可出现血清C反应蛋白升高、低蛋白血症、球蛋白增多、白细胞增多等。病理以浆细胞型为主(56%)。3例病情无进展,6例手术后部分缓解。结论腹盆部Castleman病需要病理检查确诊。局灶型临床症状轻微,手术治疗预后好;多中心型临床症状复杂,需要综合治疗,预后较差。

Objective To explore the diagnosis and treatment of Castleman's disease (CD) of the abdomen and pelvis.Methods The clinical data of 51 cases of abdomen and pelvis CD were analyzed retrospectively from Jan 2007 to Oct 2017 in the First Affiliated Hospital of Zhengzhou University.Patients were divided into two groups according to the different clinical classifications : Localized CD (n=42) and Multicentric CD (n=9).Results 32 cases of LCD were asymptomatic (76%), others accompanied by abdominal or waist pain, abdominal distention.The main pathological type was hyaline vascular (93%), which can be cured by surgical treatment (41/42).MCD always accompanied by multiple superficial and deep lymph node enlargement in the whole body.Most of them suffered from anemia, fever, weight loss and dyspnea.CRP increased, hypoproteinemia, globulin increased, neutropenia were found.The main pathological type was plasma cell type (56%).There were no progress in 3 cases, and 6 cases were on remission after operation.Conclusion The diagnosis of abdomen and pelvis CD depends on pathological examination.LCD clinical symptoms are mild and good prognosis after surgery.However, MCD clinical manifestations are complex, and relatively poor prognosis after comprehensive treatment.