2例儿童Castleman病临床病理分析并文献复习  

Clinicopathological analysis of Castleman disease in children:2 cases report and literature review

作　　者：庄小津 黄燕炳 林鹏 王荣 王成有[3] 许淑霞[3] ZHUANG Xiaojin;HUANG Yanbing;LIN Peng;WANG Rong;WANG Chengyou;XU Shuxia(Department of Pathology,Fujian Children′s Hospital,Fuzhou,Fujian 350000,China;Department of Pediatric Surgery,Fujian Children′s Hospital,Fuzhou,Fujian 350000,China;Department of Pathology,Fujian Maternity and Child Health Hospital,Fuzhou,Fujian 350000,China)

机构地区：[1]福建省儿童医院病理科,福建福州350000 [2]福建省儿童医院儿外科,福建福州350000 [3]福建省妇幼保健院病理科,福建福州350000

出　　处：《现代医药卫生》2025年第2期377-381,共5页Journal of Modern Medicine & Health

摘　　要：目的探讨儿童Castleman病(CD)的临床病理学特征、诊治及预后。方法回顾性分析福建省儿童医院收治的2例儿童CD患者临床及病理资料。同时检索中国知网、万方医学网、Pubmed中英文数据库对近5年相关文献进行复习总结。结果2例中1例为单中心型,临床以颈部皮下肿物为主要表现,病理类型为透明血管型,经手术切除后完全缓解;1例为多中心型,临床以发热,肝脾肿大为主要表现,病理类型为混合型,予白细胞介素-6(IL-6)受体拮抗剂治疗,预后良好。文献检索共获得符合要求文献11篇,12例CD患儿,包括该研究的2例共14例,其中单中心型10例,多中心型4例。单中心型CD患儿中8例病理表现为透明血管型,浆细胞型及混合型各1例,经手术治疗完全缓解,多中心型CD患儿中3例为混合型,1例为透明血管型,采取综合治疗(手术联合化疗),预后良好。结论Castleman病是儿童较罕见的疾病,其诊断需要结合临床、影像及病理综合判断,提高对该病的认识,有助于减少漏诊、误诊。Objective To explore the clinicopathological characteristics,diagnosis,treatment and prognosis of Castleman disease in children.Methods The clinical and pathological data of 2 children with Castleman disease(CD)admitted to Fujian Children′s Hospital were retrospectively analyzed,and the related literatures in the past five years were reviewed and summarized by searching CNKI,Wanfang Medical Network,and Pubmed Chinese and English databases.Results Among the 2 cases,1 case was unicentric type,the main clinical manifestations were subcutaneous tumor of the neck,the pathological type was clear vascular type,and the patient was completely relieved after surgical resection.One case was multicentric,with fever and hepatosplenomegalysis as the main clinical manifestations.The pathological type is mixed,and the prognosis was good after treatment with interleukin-6(IL-6)receptor antagonist.A total of 11 literatures with 12 cases of CD were obtained,including 2 cases in this study and a total of 14 cases,including 10 cases of unicentric type and 4 cases of multicentric type.Among the single center type CD patients,8 cases showed clear vascular type,1 plasma cell type,and 1 mixed type,which were completely relieved after surgical treatment.Among the children with multicenteric type CD,3 cases were mixed type,and 1 case was clear vascular type and the prognosis was good after comprehensive treatment(surgery combined with chemotherapy).Conclusion Castleman disease is a rare disease in children,and diagnosis needs to be combined with clinical,imaging,and pathological comprehensive judgment to improve understanding of the disease and help reduce missed diagnosis and misdiagnosis.

关 键 词：CASTLEMAN病 病理特征 诊断 治疗 儿童 淋巴组织增生 

分 类 号：R733.4[医药卫生—肿瘤]