胸内巨大淋巴结增生症的诊断与外科治疗预后研究(附16例分析)  

Diagnosis and prognosis of 16 cases of intrathoracic giant lymph node hyperplasia

作　　者：张连斌[1] 初向阳[1] 王波[1] 孙玉鹗[1] 刘颖[1] 

机构地区：[1]解放军总医院胸外科,北京100853

出　　处：《实用临床医药杂志》2010年第1期1-3,6,共4页Journal of Clinical Medicine in Practice

基　　金：军队"十一五"课题资助项目(08G120)

摘　　要：目的回顾总结胸内巨大淋巴结增生症（CD）的临床特点、诊断和外科治疗效果。方法分析1982～2009年收治的16例胸内巨大淋巴结增生症患者，男女各8例，年龄19--52岁[（35．37±10．00）岁]，均行手术治疗，另有2例分别行术前、术后放疗。随访10-318个月。结果术前确诊1例。局限性巨大淋巴结增生症13例（HV型11例，PC型1例，Mix型1例），多中心性巨大淋巴结增生症3例（PC型1例，Mix型2例），所有病例术后均生存，其中13例局限型和2例多中心型CD术后无复发。1例多中心Mix型患者于术后第4年、第9年各复发1次，均再次手术治疗。结论胸内巨大淋巴结增生症的诊断主要依靠病理学，胸内局限型CD和部分多中心型CD经彻底手术可获治愈；部分胸内多中心型CD手术治疗效果不佳，应辅助放射或其他综合治疗手段，但预后仍较差。Objective To summarize the clinical characteristics, diagnosis and surgical treatment of intrathoracic giant lymph node hyperplasia（Castteman＇s disease, CD）. Methods From 1982 to 2009, 16 patients with intrathoracic giant lymph node hyperplasia underwent surgical treatment. The clinicopathological data were retrospectively analyzed. There were 8 males and 8 females, with age ranging from 19 to 52 years old. The clinicopathological characteristics, radiological signs, treatment and prognosis were analyzed retrospectively. Results There were 13 cases of localized type patients （11 cases with hyaline vascular type, 1 case with plasma type and 1 case with mixed type） and 3 cases of multicentric type patients（ 1 cases with plasma type, 2 cases with mixed type）. All patients survived after surgical resection. Long- term survival was achieved in 13 cases with localized type and 2 cases with multicentric type, without recurrence. 1 case with multicentric type had recurrence twice. Conclusions The diagnosis of giant lymph node hyperplasia is based on its histopathological characteristics. It can be curative with surgical resection for patients with the intrathoracic localized type or some multicentric type giant lymph node hyperplasia. Some patients with intrathoracic multicentric type giant lymph node hyperplasia should be candidates for multimodality therapy including surgical management.

关 键 词：巨大淋巴结增生症 诊断 手术 预后 

分 类 号：R654.7[医药卫生—外科学]