腹部Castleman病13例临床病理特点、诊断与鉴别诊断分析  

Clinicopathologic feaures and differential diagnosis of abdominal Castleman disease

作　　者：肖欣 冯菲 何妙侠[3] 朱明华[3] 

机构地区：[1]枣庄市市中区人民医院病理科,山东枣庄277101 [2]杨浦区疾病预防控制中心,上海200090 [3]第二军医大学长海医院病理科,上海200433

出　　处：《诊断病理学杂志》2014年第3期129-133,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨腹部Castleman病的临床病理特点、诊断及鉴别诊断。方法对13例腹部Castleman病进行临床资料分析、病理形态观察、免疫组化检测、EB病毒原位杂交检测及基因重排分析。结果 13例腹部Castleman病中,11例为单中心性,2例为多中心性;10例为透明血管型,2例为浆细胞型,1例为混合型。免疫组化无特征性改变;EBER原位杂交示4例透明血管型Castleman病阳性。IG和TCR基因重排显示大部分无单克隆性基因重排条带,仅1例浆细胞型和1例混合型腹腔Castleman病有单克隆性重排条带。结论腹部Castleman病较为少见,临床与病理形态学上具有特征性,对鉴别诊断具有重要意义。Objective To discuss the clinicopathologic features and differential diagnosis of abdominal Castleman disease. Methods Thirteen cases of abdominal Castleman disease were investigated clinicopathologically, and immunohistochemically. Epstein-Barr virus was detected with in situ hybridization（EBER-ISH） and immunglobin（IG） and T cell receptor （TCR） gene rearrangements were analyzed by PCR. Results There were 11 unicenrtic cases and 2 multicentric cases in thirteen cases of abdominal Castleman disease. Pathologically, there were 11 hayline vascular types, one plasmatcyic type and one mixed type in thirteen cases of abdominal Castleman disease. Immunhistochemical results were not specific. The results of EBER-ISH showed positve signal in 4 hayline vascular cases and IG and TCR gene rearrangement showed monoclonal gene rearrangement of both IG and TCR in one plasmacytic type and one mixed type. Conclusions Abdominal Castleman disease is a rare lymphoproliferative lesion. Most of them have specific clinical and pathological features and differential diagnosis is very important.

关 键 词：CASTLEMAN病 腹部 临床病理特征 诊断与鉴别诊断 

分 类 号：R733.4[医药卫生—肿瘤]