皮肤受累的多中心Castleman病3例临床病理分析

Clinicopathologic analysis of multicentric Castleman's disease involved in the skin

目的:探讨皮肤受累的多中心Castleman病的临床和皮损组织病理特点,并且对皮损组织以浆细胞浸润为主的病变进行鉴别诊断。方法:回顾性分析3例以皮损为首发症状的多中心Castleman病,并进行文献复习。结果:3例患者中2例皮损表现为面部及躯干散在棕红色结节或斑块,1例表现为四肢为主的褐黑色浸润性斑片。皮损组织病理检查均显示真皮内淋巴细胞及成熟浆细胞浸润,血管增生明显,淋巴结活检确诊为Castleman病,浆细胞型。3例患者均不伴有人疱疹病毒(HHV)8感染。结论:多中心Castleman病直接累及皮肤罕见,不伴HHV8感染的Castleman病进展缓慢,需长期随诊并给予适当的治疗。

Objective:To study clinical and dermatopathologic features of multicentric Castleman’s disease with skin involvement,and to differentiate the diagnosis of the disorders manifested predominantly by infiltration of plasma cells.Methods:Retrospective analysis of three cases of multicentric Castleman’s disease with initial presentation of skin lesions and literature review.Results:Three cases of Castleman’s disease with skin involvement were reported.Two cases presented with scattered red-brown nodules and plaques on the face and trunk,and the third one presented with infiltrative brown-black patches on the extremities.Skin biopsy showed dermal lymphoplasmacytic infiltrate with vessel proliferation.The histopathologic features of enlarged lymph node confirmed the diagnosis of Castleman’s disease,plasma cell type.None of these cases had any evidence of HHV8 infection.Conclusions:Multicentric Castleman’s disease rarely involves the skin.Castleman’s disease with no HHV8 infection and slow progression requires long-term follow-up and appropriate treatments.