淋巴结内Castleman病临床病理分析  

The clinicpathologic study of Castleman disease

作　　者：姚秀芳[1] 

机构地区：[1]如东县人民医院病理科,江苏226400

出　　处：《交通医学》2008年第4期351-353,共3页Medical Journal of Communications

摘　　要：目的:探讨Castleman病的临床病理学特征及诊断、鉴别诊断。方法:通过组织学、免疫组化方法对5例Castleman病进行分析研究,并结合文献加以讨论。结果:3例为透明血管型,表现为增生的淋巴结内散在分布大型的淋巴滤泡,滤泡中心血管壁玻璃样变,其内可见核成空泡状的滤泡树突状细胞,外套层明显增厚,小淋巴细胞呈同心圆状包绕于血管周围,形成特征性的"洋葱皮"样同心圆结构。2例浆细胞型,特点是滤泡内的毛细血管玻璃样变性和"洋葱皮"样改变不明显,滤泡间可见粉染的无定型的嗜酸性物质沉积,并有大量成熟浆细胞弥漫增生。结论:Castleman病是一种特殊类型的淋巴结增生性疾病,诊断时要与反应性滤泡性增生、淋巴瘤等进行鉴别,并注意是否发生淋巴瘤等恶性转化。Objective：To study the clinical and pathologic features as well as the differential diagnosis of Castleman disease. Methods：Histological appearances and immunohistochemisty were applied to analyze 5 eases of Castleman disease with review of literature. Results：3 in 5 eases of Castleman diseases were hyaline-vascular type, which showed the proliferation lymph node scattered in the large-scale distribution of the lymphoid follicles, the follicles Centre vessel wall of glass-like change, as seen in the vesicular nuclei presented follicular dentritic cells. There was a tight concentric laying of lymphocytes at the periphery of follicles （corresponding to the mantle zone）, resulting in a characteristic of the ＂onion＂-like structure of concentric circles. The other 2 eases were plasma cell type that characterized by diffuse mature plasma cell proliferation in the interfollicular tissue. The glass-like vascular changes and ＂ onion＂-like change in the follicles were not obvious. Conclusion：Castleman disease is a special type of lymph node proliferate disease, can occur at any age. Differential diagnosis of it includes reactive follicular hyperplasia and lymphoma, and special attention should be paid to eases with probable malignant transformation.

关 键 词：CASTLEMAN病 免疫组化 诊断 鉴别诊断 

分 类 号：R551.2[医药卫生—血液循环系统疾病]