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腹膜后Castleman病CT表现

Castleman病是一种少见的慢性淋巴组织增生性疾病，病因不明。临床将其分为单中心型、多中心型，病理学分为透明血管性、浆细胞性及混合型。发生于腹膜后的Castleman病罕见，现对腹膜后Castleman病临床、病理、CT表现进行综述，主要是对其CT表现进行综述，以提高对该病的认识。

纵隔Castleman病一例报告及文献复习

Castleman 病为一种较少见、原因不明的不典型淋巴组织增殖性疾病, 又称血管滤泡性淋巴组织增生、巨大淋巴结病或血管瘤性淋巴错构瘤[ 1 ] 。由于缺乏特征, 临床表现多样, 加之临床少见, 故本病误诊和漏诊率均较高[ 2 ] 。我们总结了我科近期收治的1 例以纵隔淋巴结肿大为临床表现的Castleman 病例并复习了有关文献, 旨在加强对Castleman 病的认识, 提高对该病的诊治水平。

Surgical Treatment of Intrathoracic Castleman Disease

Objective To investigate the clinicopathological characteristics and surgical treatment of intrathoracic Castleman disease(CD). Methods Clinical data of 14 cases pathologically diagnosed as CD as analysed retrospectively. There were 6 males and 8 females, with an average age of 29 years(17-58). All were undergone surgical resection or biopsy. Among the 12 patients who had unicentric CD, 11 were performed open thoracotomy and lymphadenectomy with posterolateral or sternum approach, and one was treated by video assisted mini thoracotomy(VAMT). For the diagnosis of multicentric CD, one of the 2 patients had video assisted thoracic surgery(VATS) and wedge resection of the lung, and the other had video mediastinoscopy. Results No patient died perioperatively. All were successfully restored except two complications. One had dyspnea in the second postoperative day, as a result of the softening and collapse of bronchial wall in the entrance of the right main bronchus, which revealed by bedside fiberoptic bronchoscopy. One who had lymphadenopathy in the aortopulmonary window suffered from transient hoarseness after surgery. They recovered after symptomatic treatment finally. Regarding pathological classification, there were 11 cases of hyaline vascular type, 2 cases of plasma cell type and 1 case of mixed cellularity type. 13 cases were followed up for 8-110 months and longterm survive was achieved. No recurrence was observed in the 11 cases with unicentric CD and no relapse was occurred in the 2 cases with multicentric CD. Conclusion Both freezing pathology during operation and paraffin pathology postoperation are important for establishing the diagnosis. For unicentric CD, the clinical symptoms are significantly alleviated and it can be universally cured after operation. Multicentric CD needs multiple therapies after the diagnostic procedure and close follow-up.

Surgical Treatment of Intrathoracic Castleman Disease

Objective To investigate the clinicopathological characteristics and surgical treatment of intrathoracic Castleman disease(CD). Methods Clinical data of 14 cases athologically diagnosed as CD as analysed retrospectively. There were 6 males and 8 females, with an average age of 29 years(17-58). All were undergone surgical resection or biopsy. Among the 12 patients who had unicentric CD, 11 were performed open thoracotomy and lymphadenectomy with posterolateral or sternum approach, and one was treated by video assisted mini thoracotomy(VAMT). For the diagnosis of multicentric CD, one of the 2 patients had video assisted thoracic surgery(VATS) and wedge resection of the lung, and the other had video mediastinoscopy. Results No patient died perioperatively. All were successfully restored except two complications. One had dyspnea in the second postoperative day, as a result of the softening and collapse of bronchial wall in the entrance of the right main bronchus, which revealed by bedside fiberoptic bronchoscopy.One who had lymphadenopathy in the aortopulmonary window suffered from transient hoarseness after surgery. They recovered after symptomatic treatment finally. Regarding pathological classification, there were 11 cases of hyaline vascular type, 2 cases of plasma cell type and 1 case of mixed cellularity type. 13 cases were followed up for 8-110 months and longterm survive was achieved. No recurrence was observed in the 11 cases with unicentric CD and no relapse was occurred in the 2 cases with multicentric CD. Conclusion Both freezing pathology during operation and paraffin pathology postoperation are important for establishing the diagnosis. For unicentric CD, the clinical symptoms are significantly alleviated and it can be universally cured after operation. Multicentric CD needs multiple therapies after the diagnostic procedure and close follow-up.

颈部Castleman病围手术期护理一例

Castleman Disease

Castleman病9例报道

目的总结Castleman病的临床特征及诊治经验。 方法回顾性分析2010年1月至2014年12月期间我院收治的9例Castleman病患者的临床资料。 结果本组患者发病部位以颈部多见（4例），病理分型以透明血管型多见（5例），5例局灶型Castleman病患者经手术治疗取得良好效果；3例多中心型Castleman病患者经环磷酰胺+多柔比星+长春新碱+泼尼松（CHOP）化疗后病情得到好转，1例中心型Castleman病患者因基础疾病未化疗而复发。 结论Castleman病是一种罕见的淋巴系统增生性疾病，无特异性表现，诊断依赖于病理组织学，手术是治疗局灶型Castleman病的首选方法，CHOP化疗方案是治疗中心型Castleman病的一种有效方案。

胰腺 Castleman 病 1 例报道并文献复习

目的 总结 1 例胰腺 Castleman 病患者的临床资料，并复习以往文献，总结该病的流行病学特点及诊治体会。 方法 回顾性分析 2016 年 1 月笔者所在医院收治的 1 例胰腺 Castleman 病患者的临床资料，进行文献复习及总结。 结果 该例患者无特殊临床表现，术前行 CT 检查发现胰腺占位，行手术切除，术后病理学诊断为胰腺 Castleman 病。术后 1 个月复查CT未见肿瘤复发及转移，已获访 6 个月，患者恢复良好。经查阅文献，共检索出胰腺 Castleman 病 32 例，男 11 例，女 21 例；年龄 23～74 岁，平均年龄为 46 岁；临床表现仅为腹部疼痛 7 例，腹痛伴发热 1 例，腹痛伴面部、双下肢水肿 1 例，腹痛伴乏力 1 例，腹胀 1 例，背部疼痛 1 例，颈部淋巴结肿大 1 例，吞咽困难 1 例，发热、乏力、体质量下降 1 例，无明显临床表现 17 例；肿瘤位于胰腺头部 9 例，胰腺颈部 3 例，胰腺体、尾部 16 例，胰周 4 例；肿瘤直径最小 1.5 cm，最大 7.2 cm；病理学分型为透明血管型（hyaline vascular，HV）19 例，浆细胞型（plasma cell，PC）4 例，混合型（mixed/HV-PC，MV）4 例，未给出明确病理分型 5 例。 结论 胰腺 Castleman 病是少见的淋巴组织增生性疾病，通常无特异临床表现，影像学检查也无特异性，目前仅能通过病理组织学检查确诊。胰腺 Castleman 病的治疗以手术为主，疗效较好。

胰腺颈部Castleman病1例报道