中华消化外科杂志
中華消化外科雜誌
중화소화외과잡지
CHINESE JOURNAL OF DIGESTIVE SURGERY
2010年
4期
273-275
,共3页
Castleman病%诊断%治疗
Castleman病%診斷%治療
Castleman병%진단%치료
Castleman disease%Diagnosis%Treatment
目的 总结腹部Castleman病的诊断和治疗经验.方法 回顾性分析1985年6月至2009年3月北京协和医院收治的17例腹部Castleman病患者的临床资料.11例患者无任何症状,2例表现为腹部包块,2例表现为口腔溃疡、皮疹,1例表现为浮肿、气短,1例表现为上腹部隐痛、恶心、呕吐.2例行X线检查,17例行超声检查,13例行CT检查.结果 4例术前经CT检查诊断为Castleman病,其余13例均未明确诊断.14例局灶型患者经手术完整切除肿瘤,3例多中心型患者行部分切除或活组织检查.所有患者经病理检查确诊,其中14例透明血管型患者的免疫组织化学检查结果为CD3、CD20、CD21、CD34阳性;3例浆细胞型患者的免疫组织化学检查结果为CD3、CD68、PCNA阳性.17例患者中1例失访,16例随访3～12个月无转移和复发.结论 腹部Castleman病临床表现无特异性,术前诊断困难.局灶型患者应尽早行手术完整切除,预后良好;多中心型难以完整切除,可于术后进行化疗,预后较好.
目的 總結腹部Castleman病的診斷和治療經驗.方法 迴顧性分析1985年6月至2009年3月北京協和醫院收治的17例腹部Castleman病患者的臨床資料.11例患者無任何癥狀,2例錶現為腹部包塊,2例錶現為口腔潰瘍、皮疹,1例錶現為浮腫、氣短,1例錶現為上腹部隱痛、噁心、嘔吐.2例行X線檢查,17例行超聲檢查,13例行CT檢查.結果 4例術前經CT檢查診斷為Castleman病,其餘13例均未明確診斷.14例跼竈型患者經手術完整切除腫瘤,3例多中心型患者行部分切除或活組織檢查.所有患者經病理檢查確診,其中14例透明血管型患者的免疫組織化學檢查結果為CD3、CD20、CD21、CD34暘性;3例漿細胞型患者的免疫組織化學檢查結果為CD3、CD68、PCNA暘性.17例患者中1例失訪,16例隨訪3～12箇月無轉移和複髮.結論 腹部Castleman病臨床錶現無特異性,術前診斷睏難.跼竈型患者應儘早行手術完整切除,預後良好;多中心型難以完整切除,可于術後進行化療,預後較好.
목적 총결복부Castleman병적진단화치료경험.방법 회고성분석1985년6월지2009년3월북경협화의원수치적17례복부Castleman병환자적림상자료.11례환자무임하증상,2례표현위복부포괴,2례표현위구강궤양、피진,1례표현위부종、기단,1례표현위상복부은통、악심、구토.2례행X선검사,17례행초성검사,13례행CT검사.결과 4례술전경CT검사진단위Castleman병,기여13례균미명학진단.14례국조형환자경수술완정절제종류,3례다중심형환자행부분절제혹활조직검사.소유환자경병리검사학진,기중14례투명혈관형환자적면역조직화학검사결과위CD3、CD20、CD21、CD34양성;3례장세포형환자적면역조직화학검사결과위CD3、CD68、PCNA양성.17례환자중1례실방,16례수방3～12개월무전이화복발.결론 복부Castleman병림상표현무특이성,술전진단곤난.국조형환자응진조행수술완정절제,예후량호;다중심형난이완정절제,가우술후진행화료,예후교호.
Objective To summarize the diagnosis and treatment of abdominal Castleman disease.Methods The clinical data of 17 patients with abdominal Castleman disease who were admitted to Peking Union Medical College Hospital were retrospectively analysed. Eleven patients had no symptoms, two had an abdominal mass, two had oral ulcers and rash, one had edema and was short of breath and one had dull pain in the upper abdomen and vomiting. Two patients were examined by X-ray, 17 by ultrasound, and 13 by computed tomography(CT). Results Four patients were diagnosed with abdominal Castleman disease by CT preoperatively, and the remaining 13 patients were not conclusively diagnosed. Localized lesions of 14 patients were completely resected,and three patients with multicentric lessions received partial resection or biopsy. The diagnosis of all patients was confirmed by histopathological examination. The expression of CD3, CD20, CD21 and CD34 of 14 patients with hyaline-vascular type was positive, and the expression of CD3, CD68 and PCNA of three patients with plasma-cell type was positive. One patients was lost of follow up, and the remaining 16 patients were followed up for 3-12 months, and neither metastasis nor recurrence was observed. Conclusions The clinical manifestations of abdominal Castleman disease are nonspecific, and therefore, it is difficult to acquire a definite diagnosis before operation. Early complete resection should be applied to patients with localized Castleman disease, while for patients with multicentric Castleman disease, postoperative chemotherapy is necessary for a good prognosis.
