3例胸腔Castl的eman病临床病理特点分析.pdf

30 实用医院临床杂志 2013年7月第 10卷第 4期 3例胸腔 Castleman病临床病理特点分析 陈勃江 ，李为民 ，张尚福b，高 b罗 又a，赵 爽 (四川大学华西医院 a．呼吸内科，b．病理科，四川 成都 610041) 【摘要】 目的 探讨胸腔Castleman病的临床病理特点。方法 回顾性分析3例胸腔Castleman病患者的临床病理资 料。结果 3例患者均为中青年。病灶均位于右侧胸腔，靠近或位于纵隔，CT表现为局灶肿块性圆形或类圆形软组织密度 影。3例患者术前均初诊为右肺或纵隔占位，其中2例考虑可疑肺癌。3例患者均行开胸手术治疗，术后组织病理活检证实为 Castleman病，其中2例为透明血管型，1例为浆细胞型。电话随访患者预后较好，无复发或并发症发生。结论 Castleman病 患者临床缺乏特异性表现，降低其误诊误治率依赖于仔细甄别其影像学特征并及时予以手术和组织病理活检。 【关键词】 Castleman病；诊断；治疗 【中图分类号】R632．6；R733．4 【文献标志码】A 【文章编号】1672-6170(2013)04-0030-04 Clinicopathologic characteristics Of three cases with thoracic cavity Castleman disease C加 Ⅳ Bo r上 ，LI耽 —min。，ZHANG Shang-fu ， 0 Jun ，LUO Man。，删 O Shuang。 (a．Department ofRespirato- ry，b．Department of Pathology，West China Hospital，Sichuan University，Chengdu 610041，China) 【Corresponding author l L／Wei—min 【Abstract】 Objective To study the clinicopathologic features of thoracic cavity Castleman disease．Methods Data of three patients diagnosed with thoracic cavity Castleman disease by histopathology were retrospectively analyzed．Results Al of the three pa- tients were middle—aged．CT scans showed that al lesions were located in the fight side of the thoracic cavity，close to or in the mediasti— nun．The lesions were al characterized by focal round or oval mass soft tissues，which led to a primary diagnosis of fight lung or medias— tinal space—occupying lesions，and two of them were suspected as lung cancer．Al patients received thoracotomy surgical treatments and histopathologic examinations confirmed the diagnosis of Castleman disease．Two cases were hyaline vascular type while one case was plasma cell type．By the phone call folowing—up，all patients revealed a satisfying postoperative prognosis，without any complication or recurrence．Conclusion The clinical features of thoracic cavity Castleman disease were nonspecifc．Care~l screening of its imaging features，timely surgery and pathological tissue biopsy may be an effective way to reduce its misdiagnosis and mistreatment rate． 【Key words】 Castl