中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2010年
2期
96-98
,共3页
巨淋巴结增生%天疱疮%胸外科手术
巨淋巴結增生%天皰瘡%胸外科手術
거림파결증생%천포창%흉외과수술
Giant lymph node hyperplasia%Pemphigus%Thoracic surgical procedures
目的 探讨胸部局限性Castleman病的临床特征及外科治疗方法.方法 回顾性分析1996年6月至2008年11月收治的32例胸部局限性Castleman病患者的临床资料,探讨该病的临床和病理特点,总结其外科治疗效果.32例患者中男性14例,女性18例,年龄16～48岁,平均34.2岁.其中8例患者表现为胸闷、气短;3例患者表现为刺激性干咳;2例患者表现为胸痛;14例患者无临床症状,为体检时偶尔发现.CT检查均发现纵隔或肺门单发肿瘤.结果 除1例因术中麻醉意外死亡外,其余患者全部行手术完整切除肿瘤,病理改变符合Castleman病,病理类型以透明血管型为主.5例患者伴有副肿瘤性天疱疮,其中3例出现闭塞性细支气管炎;常规激素治疗均尤效,肿瘤切除后药物治疗1～2个月皮损明显好转,但肺部病变持续加重.术后随访全部患者均未见肿瘤复发.结论 胸部局限性Castleman病是一种罕见的胸部疾病,副肿瘤性天疱疮和肺部异常为Castleman病的少见而严重的合并症,手术切除肿瘤为首选治疗.
目的 探討胸部跼限性Castleman病的臨床特徵及外科治療方法.方法 迴顧性分析1996年6月至2008年11月收治的32例胸部跼限性Castleman病患者的臨床資料,探討該病的臨床和病理特點,總結其外科治療效果.32例患者中男性14例,女性18例,年齡16～48歲,平均34.2歲.其中8例患者錶現為胸悶、氣短;3例患者錶現為刺激性榦咳;2例患者錶現為胸痛;14例患者無臨床癥狀,為體檢時偶爾髮現.CT檢查均髮現縱隔或肺門單髮腫瘤.結果 除1例因術中痳醉意外死亡外,其餘患者全部行手術完整切除腫瘤,病理改變符閤Castleman病,病理類型以透明血管型為主.5例患者伴有副腫瘤性天皰瘡,其中3例齣現閉塞性細支氣管炎;常規激素治療均尤效,腫瘤切除後藥物治療1～2箇月皮損明顯好轉,但肺部病變持續加重.術後隨訪全部患者均未見腫瘤複髮.結論 胸部跼限性Castleman病是一種罕見的胸部疾病,副腫瘤性天皰瘡和肺部異常為Castleman病的少見而嚴重的閤併癥,手術切除腫瘤為首選治療.
목적 탐토흉부국한성Castleman병적림상특정급외과치료방법.방법 회고성분석1996년6월지2008년11월수치적32례흉부국한성Castleman병환자적림상자료,탐토해병적림상화병리특점,총결기외과치료효과.32례환자중남성14례,녀성18례,년령16～48세,평균34.2세.기중8례환자표현위흉민、기단;3례환자표현위자격성간해;2례환자표현위흉통;14례환자무림상증상,위체검시우이발현.CT검사균발현종격혹폐문단발종류.결과 제1례인술중마취의외사망외,기여환자전부행수술완정절제종류,병리개변부합Castleman병,병리류형이투명혈관형위주.5례환자반유부종류성천포창,기중3례출현폐새성세지기관염;상규격소치료균우효,종류절제후약물치료1～2개월피손명현호전,단폐부병변지속가중.술후수방전부환자균미견종류복발.결론 흉부국한성Castleman병시일충한견적흉부질병,부종류성천포창화폐부이상위Castleman병적소견이엄중적합병증,수술절제종류위수선치료.
Objective To explore the clinical features and surgical treatment of thoracic Castleman's disease. Methods The clinical symptoms, pathological, laboratory, CT findings and results of surgery in 32 patients with Castleman's disease from June 1996 to November 2008 were evaluated. Among the 32 patients, there were 14 male and 18 female, aged from 16 to 48 years old with a mean age of 34.2 years old. Thirteen cases had symtoms including short of breath, irritable cough, or chest pain, while 14 cases had no symptoms. Mediastinal or hilar tumors were found by CT examination. Results Tumor was surgically removed in all the 32 patients except one died with anesthetic aceidenL Castleman's disease was conformed by pathology. Five cases were diagnosed as with paraneoplastie pemphigus, 3 of them were attacked by bronchiolitis obliterans. All 5 cases were failed by the use of predisone. The signs of PNP were dissolved after operation, but pulmonary lesions failed to improve. There was no recurrence in all cases.Conclusions PNP and lung abnormalities are the rare and severe complications of thoracic Castleman's disease. Surgical resection of the tumor is the first choice for treatment.
