Castleman病的临床特征及疗效分析

Analysis of therapeutic effect and clinical features of Castleman disease

目的分析Castleman病(CD)的临床特征及疗效。方法选取2010年1月—2014年10月泸州医学院附属医院血液内科收治的CD患者8例,回顾性分析其临床特征及疗效。结果 8例患者病理分型为透明血管型(HV-CD)4例,浆细胞型(PC-CD)4例;临床分型为局灶型(LCD)3例,多中心型(MCD)5例。LCD患者中1例临床表现为颈部淋巴结无痛性肿大,2例胸部CT提示为胸腔内前纵隔淋巴结肿大,临床表现为胸闷、咳嗽,无其他全身症状表现;MCD患者均有不同程度的发热、盗汗、乏力、体质量下降等全身症状,部分患者伴有肝脾大、不同程度水肿、皮肤改变等。LCD患者实验室检查结果显示淋巴结肿大;MCD患者均伴不同程度贫血、红细胞沉降率增快、低蛋白血症、肝功能异常、乳酸脱氢酶增高等。LCD患者均行手术切除治疗;MCD患者予以CHOP或COP方案化疗,治疗后MVD患者完全缓解(CR)3例,部分缓解(PR)1例,疾病稳定(SD)1例。结论 CD患者的临床表现具有异质性,诊断主要依靠组织病理学检查,联合化疗是一种有效的治疗手段。

Objective To analyze therapeutic effect and clinical features of Castleman disease( CD). Methods A total of 8 patients with CD were selected in the Affiliated Hospital of Luzhou Medical College in Department of Hemopathology from January 2010 to October 2014,retrospective analysis the clinical features and curative effect. Results 8 cases of patients with pathologic classification for hyaline- vascular type castleman disease( HV- CD) 4 cases,plasmacyte type castleman disease( PC- CD) 4 cases; clinical classification for focal type castleman disease( LCD) 3 cases,multicentric type castleman disease( MCD) 5 cases. LCD patients 1 case presented with painless enlargement to the cervical lymph nodes,2 cases of chest CT tips for intrathoracic before mediastinal lymph node enlargement,clinical manifestations of chest tightness,cough,No other systemic symptoms; MCD patients have different degree of fever, night sweats, fatigue, body quality and body symptoms,some patients with liver and spleen enlargement,different degree of edema,skin changes. LCD laboratory examination results show that the lymph node enlargement; MCD patients with different degree of anemia,blood sedimentation rate,hypoalbuminemia,liver meritorious service is abnormal,the rapid increased lactate dehydrogenase. LCD patients were performed surgical removal of the treatment; MCD patients were CHOP or COP program chemotherapy,after treatment MVD patients with CR 3 cases,PR 1 case,SD 1 case. Conclusion CD patients with clinical manifestations have heterogeneity,the diagnosis relies mainly on the histopathological examination,combination chemotherapy is an effective treatment.