Search

胰腺 Castleman 病 1 例報道并文獻復習

目的 總結 1 例胰腺 Castleman 病患者的臨床資料，并復習以往文獻，總結該病的流行病學特點及診治體會。 方法 回顧性分析 2016 年 1 月筆者所在醫院收治的 1 例胰腺 Castleman 病患者的臨床資料，進行文獻復習及總結。 結果 該例患者無特殊臨床表現，術前行 CT 檢查發現胰腺占位，行手術切除，術后病理學診斷為胰腺 Castleman 病。術后 1 個月復查CT未見腫瘤復發及轉移，已獲訪 6 個月，患者恢復良好。經查閱文獻，共檢索出胰腺 Castleman 病 32 例，男 11 例，女 21 例；年齡 23～74 歲，平均年齡為 46 歲；臨床表現僅為腹部疼痛 7 例，腹痛伴發熱 1 例，腹痛伴面部、雙下肢水腫 1 例，腹痛伴乏力 1 例，腹脹 1 例，背部疼痛 1 例，頸部淋巴結腫大 1 例，吞咽困難 1 例，發熱、乏力、體質量下降 1 例，無明顯臨床表現 17 例；腫瘤位于胰腺頭部 9 例，胰腺頸部 3 例，胰腺體、尾部 16 例，胰周 4 例；腫瘤直徑最小 1.5 cm，最大 7.2 cm；病理學分型為透明血管型（hyaline vascular，HV）19 例，漿細胞型（plasma cell，PC）4 例，混合型（mixed/HV-PC，MV）4 例，未給出明確病理分型 5 例。 結論 胰腺 Castleman 病是少見的淋巴組織增生性疾病，通常無特異臨床表現，影像學檢查也無特異性，目前僅能通過病理組織學檢查確診。胰腺 Castleman 病的治療以手術為主，療效較好。

Castleman Disease

Castleman病9例報道

目的總結Castleman病的臨床特征及診治經驗。 方法回顧性分析2010年1月至2014年12月期間我院收治的9例Castleman病患者的臨床資料。 結果本組患者發病部位以頸部多見（4例），病理分型以透明血管型多見（5例），5例局灶型Castleman病患者經手術治療取得良好效果；3例多中心型Castleman病患者經環磷酰胺+多柔比星+長春新堿+潑尼松（CHOP）化療后病情得到好轉，1例中心型Castleman病患者因基礎疾病未化療而復發。 結論Castleman病是一種罕見的淋巴系統增生性疾病，無特異性表現，診斷依賴于病理組織學，手術是治療局灶型Castleman病的首選方法，CHOP化療方案是治療中心型Castleman病的一種有效方案。

縱隔Castleman病一例報告及文獻復習

Castleman 病為一種較少見、原因不明的不典型淋巴組織增殖性疾病, 又稱血管濾泡性淋巴組織增生、巨大淋巴結病或血管瘤性淋巴錯構瘤[ 1 ] 。由于缺乏特征, 臨床表現多樣, 加之臨床少見, 故本病誤診和漏診率均較高[ 2 ] 。我們總結了我科近期收治的1 例以縱隔淋巴結腫大為臨床表現的Castleman 病例并復習了有關文獻, 旨在加強對Castleman 病的認識, 提高對該病的診治水平。

腹膜后Castleman病CT表現

Castleman病是一種少見的慢性淋巴組織增生性疾病，病因不明。臨床將其分為單中心型、多中心型，病理學分為透明血管性、漿細胞性及混合型。發生于腹膜后的Castleman病罕見，現對腹膜后Castleman病臨床、病理、CT表現進行綜述，主要是對其CT表現進行綜述，以提高對該病的認識。

胰腺頸部Castleman病1例報道

頸部Castleman病圍手術期護理一例

Surgical Treatment of Intrathoracic Castleman Disease

Objective To investigate the clinicopathological characteristics and surgical treatment of intrathoracic Castleman disease(CD). Methods Clinical data of 14 cases athologically diagnosed as CD as analysed retrospectively. There were 6 males and 8 females, with an average age of 29 years(17-58). All were undergone surgical resection or biopsy. Among the 12 patients who had unicentric CD, 11 were performed open thoracotomy and lymphadenectomy with posterolateral or sternum approach, and one was treated by video assisted mini thoracotomy(VAMT). For the diagnosis of multicentric CD, one of the 2 patients had video assisted thoracic surgery(VATS) and wedge resection of the lung, and the other had video mediastinoscopy. Results No patient died perioperatively. All were successfully restored except two complications. One had dyspnea in the second postoperative day, as a result of the softening and collapse of bronchial wall in the entrance of the right main bronchus, which revealed by bedside fiberoptic bronchoscopy.One who had lymphadenopathy in the aortopulmonary window suffered from transient hoarseness after surgery. They recovered after symptomatic treatment finally. Regarding pathological classification, there were 11 cases of hyaline vascular type, 2 cases of plasma cell type and 1 case of mixed cellularity type. 13 cases were followed up for 8-110 months and longterm survive was achieved. No recurrence was observed in the 11 cases with unicentric CD and no relapse was occurred in the 2 cases with multicentric CD. Conclusion Both freezing pathology during operation and paraffin pathology postoperation are important for establishing the diagnosis. For unicentric CD, the clinical symptoms are significantly alleviated and it can be universally cured after operation. Multicentric CD needs multiple therapies after the diagnostic procedure and close follow-up.

Surgical Treatment of Intrathoracic Castleman Disease

Objective To investigate the clinicopathological characteristics and surgical treatment of intrathoracic Castleman disease(CD). Methods Clinical data of 14 cases pathologically diagnosed as CD as analysed retrospectively. There were 6 males and 8 females, with an average age of 29 years(17-58). All were undergone surgical resection or biopsy. Among the 12 patients who had unicentric CD, 11 were performed open thoracotomy and lymphadenectomy with posterolateral or sternum approach, and one was treated by video assisted mini thoracotomy(VAMT). For the diagnosis of multicentric CD, one of the 2 patients had video assisted thoracic surgery(VATS) and wedge resection of the lung, and the other had video mediastinoscopy. Results No patient died perioperatively. All were successfully restored except two complications. One had dyspnea in the second postoperative day, as a result of the softening and collapse of bronchial wall in the entrance of the right main bronchus, which revealed by bedside fiberoptic bronchoscopy. One who had lymphadenopathy in the aortopulmonary window suffered from transient hoarseness after surgery. They recovered after symptomatic treatment finally. Regarding pathological classification, there were 11 cases of hyaline vascular type, 2 cases of plasma cell type and 1 case of mixed cellularity type. 13 cases were followed up for 8-110 months and longterm survive was achieved. No recurrence was observed in the 11 cases with unicentric CD and no relapse was occurred in the 2 cases with multicentric CD. Conclusion Both freezing pathology during operation and paraffin pathology postoperation are important for establishing the diagnosis. For unicentric CD, the clinical symptoms are significantly alleviated and it can be universally cured after operation. Multicentric CD needs multiple therapies after the diagnostic procedure and close follow-up.