头颈部Castleman病10例临床病理分析  

Castleman's disease of the head and neck: a clinicopathologic study of 10 cases

作　　者：程嘉[1] 周洁[1] 王国栋[1] 黄建涛[1] 陈潇卿[1] 吴洋[1] 刘渊[1] 姜蕾[1] 赵云富[1] 

机构地区：[1]第二军医大学附属长征医院口腔科,上海200003

出　　处：《中国口腔颌面外科杂志》2016年第3期257-262,共6页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市卫生局青年科研基金(2011Y52)

摘　　要：目的 :总结头颈部Castleman病(Castleman's disease,CD)的临床病理表现、诊断、治疗及预后特点。方法 :对1998年1月—2015年9月就诊于第二军医大学附属长征医院口腔科的10例CD患者的临床资料进行回顾分析,对组织病理切片进行光镜观察和免疫组织化学检测。结果:10例患者中,男6例、女4例,中位年龄44岁(19~67岁);就诊前病程15 d^8 a不等(中位病程12个月);位于腮腺3例、颈部7例;按组织病理分型,透明血管型6例,浆细胞型4例;按临床类型分类,局限性透明血管型CD 6例、局限性浆细胞型CD 2例、多中心CD 2例。结论:CD应作为头颈部肿块的鉴别对象。无论是透明血管型CD,还是浆细胞型CD,明确诊断后均应作长期观察,以及时发现疾病复发、恶变征兆。PURPOSE： To summarize the clinicopathological features, diagnosis, treatment strategies and prognosis of Castleman＇s disease（CD） in the head and neck. METHODS： We analyzed 10 cases of CD in the head and neck region with pathological diagnosis of CD treated between January 1998 and September 2015. Immunohistochemical staining was performed on paraffin-embedded tissues. RESULTS： The studied subjects consisted of 6 males and 4 females. The median age was 44 years old（range from 19 to 67 years old）. The course of disease ranged from 15 days to 8 years with a median of 12 months. The most common sign was an asymptomatic mass in head or neck region. The primary lesions included the parotid region in 3 patients and neck in 7 patients. According to histopathological subclassification, 6 cases were hyaline-vascular type（HVT） and 4 cases were plasma cell type（PCT）. Clinically, 6 cases were localized HVT-CD, 2cases were localized PCT-CD and 2 were multicentric CD. CONCLUSIONS： CD should be considered in the differential diagnosis of cervical nodal enlargements. Overgrowth of follicular dendritic cells in the hyaline vascular type of CD might represent a precursor of follicular dendritic cell sarcoma.

关 键 词：CASTLEMAN病 头颈部 临床病理学 

分 类 号：R597[医药卫生—内科学]