表现为腹腔肿物的腹膜后单中心型Castleman病  

Retroperitoneum unicentric Castleman disease manifested as abdominal lesion

作　　者：孟翔飞[1] 辛大平 李杰[3] 申安[4] 程志雷[1] 梁斌[1] 黄晓强[1] 

机构地区：[1]解放军总医院肝胆外科,北京100853 [2]四川省广安市人民医院普外科,四川广安638000 [3]解放军总医院病理科,北京100853 [4]潍坊医学院附属医院肝胆外科,山东潍坊260013

出　　处：《军医进修学院学报》2011年第2期125-127,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的报告1例罕见腹膜后单中心型Castleman病病例,提供诊疗经验,提高该病诊治水平。方法回顾性分析近期诊治并经病理学确诊的腹膜后单中心型Castleman病1例,并结合国内外文献对该病的流行病学特征、临床及病理分型、临床表现、诊断、治疗及预后进行讨论。结果女性,21岁,偶然查体发现腹腔肿物,无自觉症状及体征。CT检查发现8.0cm×7.0cm×7.7cm边界清楚富血供的上腹部肿块,无法明确来源。术中明确肿瘤来源于腹膜后,术后病理明确为Castleman病,透明血管型,结合临床所见确诊单中心型Castleman病,文献报告预后良好,仅予随访。结论Castleman病是一种罕见的淋巴增生性疾病,是腹腔占位的一种罕见原因。单中心型Castleman病手术完整切除后预后良好,可仅予随访观察。多中心型者预后较差,可选择化疗和免疫治疗。Objective To report a rare case of retroperitoneum unicentric Castleman disease（CD） and our clinical experience in its diagnosis and treatment.Methods Epidemic features,clinical and pathological typing,clinical manifestations,diagnosis,treatment and prognosis of the case were retrospectively analyzed based on the literature review.Results The patient was a 21-years old female student.She was accidentally found to have an abdominal mass with no symptoms and signs.CT revealed a mass in her upper abdomen with a clear margin and rich blood supply measuring 8.0cm×7.0cm×7.7cm.The tumor was found to be originated from the retroperitoneam during operation,which was pathologically diagnosed as a hyaline vascular（HV） CD and finally as a retroperitoneum unicentric CD according to its clinical manifestations.The prognosis of the patient was good during the follow-up.Conclusion CD is a rare lymph-proliferative and occupying abdominal disease.The prognosis of unicentric CD is good after radical surgery and the patients should be regularly followed up,while that of multicentric CD is poor and the patients should undergo chemotherapy and immune therapy.

关 键 词：巨淋巴结增生 腹腔 诊断 鉴别 

分 类 号：R656[医药卫生—外科学]