肺脏Castleman病2例并文献复习  

Two cases of pulmonary Castleman＇ s disease and literature review

作　　者：周学鲁 胡灏[2] 周上军[2] 谭学君 Zhou Xuelu;Hu Hao;Zhou Shangjun;Tan Xuejun(Department of Surgery,Chashan Hospital,Guangdong Medical University,Dongguan 523378,China)

机构地区：[1]广东医科大学附属茶山医院外科,东莞523378 [2]广州中医药大学附属东莞市中医院外科,523127 [3]广州中医药大学附属东莞市中医院病理科,523127

出　　处：《国际呼吸杂志》2018年第15期1144-1148,共5页International Journal of Respiration

摘　　要：目的 提高临床上对肺脏Castleman （PCD）病的认识及诊治水平.方法 报道2例PCD并结合相关文献进行分析讨论.结果 男女各1例,年龄分别为42岁、57岁.男性患者肿瘤位于右中下肺,腔镜手术切除,效果良好.而女性患者除了右中肺病变外,合并其他全身疾病,治疗效果较差.检索国内文献符合研究标准的有67篇共79例.按临床和影像学表现分为肺周型（31例,39.2％）、肺门型（40例,50.6％）和肺弥漫型（8例,10.1％）,大多数病例无特殊临床症状.前两者为局灶型,后者为多中心型.病理类型：透明血管型59例（74.7％）,浆细胞型6例（7.6％）,混合型4例（5.1％）,未记录10例（12.7％）.79例患者行肿物切除术或肺叶切除术70例,其余9例采用保守疗法.所有病例平均随访时间45.6个月.3例弥漫型PCD患者在治疗后24个月内死亡.结论 PCD无特异临床症状,影像学对诊断有一定价值,但确诊需靠病理.肺周型和肺门型手术切除疗效好,长期生存,而肺弥漫型治疗效果欠佳,预后差.Objective To improve the understanding and treatment of the pulmonary Castleman＇s disease （PCD）.Methods Two cases of PCD were reported and related literatures were reviewed.Results One male patient was 42 years old,and the other female patient was 57 years old.Both of them had a mass in the right pulmonary lope.The male patient received endoscopic resection and had good outcome.The female patient only had conservative treatment and the result was not satisfied.A total of 79 cases of PCD were retrieved from domestic publications.The patients were divided into peripheral type （31 cases,39.2 %）,pulmonary hilar type （40 cases,50.6 %） and diffusion type （eight cases,10.1%） in the light of clinical and imaging findings.The first two were localized,and the latter was multicentric.Pathologically,there were 59 cases of hyaline vascular type （74.7%）,six cases of plasma cell type （7.6%）,four cases of mixed type （5.1%） and ten cases of unknown （12.7%）.70 of 79 patients underwent tumor resection or lobectomy,and other nine cases had conservative treatment.The average follow-up time was 45.6 months.Three of eight diffusion patients died in 24 months after conservative treatment.Conclusions There are no specific clinical presentations in PCD.Imaging examination can be helpful for the diagnosis but the definite diagnosis should be made by pathology.Surgical resection has good outcomes in patients of peripheral and hilar type,while the patients of diffusion type often has poor prognosis.

关 键 词：CASTLEMAN病 巨大淋巴结增生 肺脏 诊断 治疗 

分 类 号：R734.2[医药卫生—肿瘤]