12例Castleman病临床诊疗分析及文献复习  

Clinical Diagnosis and Treatment and Literature Review of 12 Cases of Castleman’s Disease

作　　者：韩灵 罗文坚 张瑜[1] 崔林刚[1] 李腾 魏寅生 杨治立 韩彦通 孟庆军[1] HAN Ling;LUO Wenjian;ZHANG Yu;CUI Lin’gang;LI Teng;WEI Yinsheng;YANG Zhili;HAN Yantong;MENG Qingjun(Department of Urology,Zhengdong Hospital of the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院郑东院区泌尿外科二,河南郑州450000

出　　处：《河南医学研究》2022年第8期1413-1416,共4页Henan Medical Research

摘　　要：目的通过分析12例Castleman病(CD)患者诊治过程,了解该疾病的临床特点。方法回顾性分析郑州大学第一附属医院2013年8月至2019年5月12例CD患者临床资料。结果患者年龄7~62岁,中位年龄42岁,平均年龄38.41岁。其中3例为体检发现,5例表现为同侧腰腹部不适、疼痛,1例表现为同侧胸腔积液、胸痛,1例因头晕、乏力、低热、月经不调就诊,1例以颈部肿物就诊。单中心11例,多中心1例,肿瘤最大径39~79mm,平均54.82mm,中位最大径55mm。11例单中心型CD(UCD)患者均行手术切除,术后症状完全缓解,病理证实均为CD,10例为透明细胞型,1例未报告分型。1例多中心型CD(MCD),行开腹探查并取活检确诊,病理证实为CD,透明细胞型,给予化疗,疗效较差。结论CD是一种以淋巴结增生为特点的罕见病,好发于腹膜后、肠系膜、纵隔、颈部等区域。其临床诊断主要依靠病理诊断。UCD主要以手术治疗为主,预后较好,必要时可联合应用化疗、放疗;MCD治疗以白细胞介素-6靶向治疗为基础,可联合应用糖皮质激素或化疗方案,但预后较差。Objective To study the clinical characteristics of Castleman’s disease(CD)by analyzing the diagnosis and treatment of 12 cases.Methods Clinical data of 12 patients with CD from the First Affiliated Hospital of Zhengzhou University from August 2013 to May 2019 were retrospectively analyzed.Results The patients ranged in age from 7 to 62 years.The median age was 42 years,and the mean age was 38.41 years.Among them,3 patients were found in physical examination,5 patients presented with ipsilateral lumbar and abdominal discomfort and pain,1 patient presented with ipsilateral pleural effusion and chest pain,1 patient presented with dizziness,fatigue,low fever and irregular menstruation,and 1 patient presented with neck mass.There were 11 unicentric patients and 1 multicentric patient.The maximum diameter of tumor was 39-79 mm,with an average of 54.82 mm.All 11 patients with unicentric CD(UCD)underwent surgical resection and their symptoms were completely relieved after operation.All patients were confirmed to be Castleman’s disease by pathology.Ten patients were clear cell type and 1 patient had no reported classification.One multicentric CD(MCD)patient was confirmed by biopsy and pathologically confirmed as CD with clear cell type chemotherapy was given with poor efficacy.Conclusion CDis a rare disease characterized by lymph node hyperplasia,usually occurring in retroperitoneum,mesentery,mediastinum and neck.Its clinical diagnosis mainly depends on pathological diagnosis.UCD is mainly treated with surgery and has a good prognosis,and if necessary,combined chemotherapy and radiotherapy can be used.MCD’s treatment is based on interleukin-6 targeted therapy and can be combined with glucocorticoid or chemotherapy regiments,but the prognosis is poor.

关 键 词：CASTLEMAN病 诊断 治疗 

分 类 号：R654.7[医药卫生—外科学]