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 longterm 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.
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 longterm 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.