以腹水为主要表现的多中心型Castleman病的诊治分析  

Analysis of the Diagnosis and Treatment of Multicenter Castleman’s Disease with Ascites as the Main Manifestation

作　　者：李雨晴 任翠翠 蔡瑜[2] 田畅 贾媛媛 吴戈 

机构地区：[1]西安医学院第一附属医院全科医学科,陕西 西安 [2]西安医学院第一附属医院教师发展与评价科,陕西 西安 [3]西安医学院全科医学院,陕西 西安

出　　处：《临床医学进展》2024年第9期779-786,共8页Advances in Clinical Medicine

摘　　要：Castleman病是一种临床和病理与淋巴瘤相似的少见的淋巴增殖性疾病,其特征包括弥漫性淋巴结肿大、脾肿大、贫血、血小板增多、高球蛋白血症、血清炎性因子升高和全身炎症反应。由于该病的临床表现缺乏特异性,因此必须依靠病理学改变进行确诊,免疫组织化学染色标记可进一步明确诊断及分型。本研究报告了多中心型Castleman病患者伴有大量腹水的临床特点及诊疗策略,并进行了相关鉴别诊断的分析,为Castleman病的诊断提供了线索。在临床实践中,当患者出现全身性淋巴结肿大、伴有大量浆膜腔积液、少尿、低蛋白血症等广泛全身表现时,应根据临床表现进一步进行淋巴组织病理活检,以避免误诊或漏诊。Castleman’s disease is a rare lymphoproliferative disorder that mimics lymphoma clinically and pathologically, characterized by diffuse lymphadenopathy, splenomegaly, anemia, thrombocytosis, hyperglobulinemia, elevated serum inflammatory factors, and systemic inflammatory responses. Due to the lack of specificity of the clinical manifestations of the disease, the diagnosis must be confirmed by pathologic changes, and immunohistochemical staining markers can further confirm the diagnosis and classification. This study reported the clinical characteristics and diagnosis and treatment strategies of patients with multicenter Castleman disease with massive ascites, and analyzed the relevant differential diagnoses, which provided clues for the diagnosis of Castleman disease. In clinical practice, when patients have extensive systemic manifestations such as generalized lymphadenopathy, large serous effusion, oliguria, and hypoproteinemia, further lymphoid histopathological biopsy should be performed according to the clinical manifestations to avoid misdiagnosis or missed diagnosis.

关 键 词：CASTLEMAN病 多发性淋巴结肿大 腹水 鉴别诊断 沙利度胺 

分 类 号：R73[医药卫生—肿瘤]