累及肾脏的透明血管型Castleman病2例报道及文献复习.pdf

750 　　肿瘤2014 年8 月第34 卷第8 期　TUM OR Vol. 34, August 2014 DOI: 10.3781/j .issn.1000-7431.2014.08.012 Copyright© 2014 by TUM OR Clinical Experience 临床经验 · 累及 肾脏的透明血管型Castleman病 ：2例报道及文献复 习 朱　熹，田　野，郝钢跃，肖　荆，路　义 首都医科大学附属北京友谊医院泌尿外科，北京　100050 [ 摘要 ]　目的：提高对累及肾脏的Castleman 病诊断和治疗的认识水平。方法：总结2 例累及肾脏的透明血管型 Castleman 病患者的临床诊治资料，结合文献讨论其发病特点、影像学特征、病理学、治疗和预后。病例1 主诉为 发现左肾占位2 个月；B 超检查提示为左肾上极低回声占位，未见血流信号；CT 检查提示左肾上极稍高密度结节， 增强后略有强化。病例2 主诉为体检发现左肾盂内占位20 d ；B 超检查提示为左肾窦低回声占位，未见血流信号； CT 检查提示左肾盂团块影，增强后轻度强化；其他检查均未见异常。2 例患者分别行腹腔镜下肾部分切除术和肾 根治性切除术，术后均恢复良好。结果：术后病理诊断结果为Castleman 病，透明血管型。术后分别随访1 年和4 月余，均未见肿瘤复发。结论：Castleman 病为巨大淋巴结增生的罕见疾病，实验室检查和影像学检查并无特异性 表现。累及肾脏的Castleman 病易被误诊为肾盂或肾实质肿瘤，确诊需要依靠病理学诊断。 [ 关键词 ]　Castleman 病；肾脏；淋巴结 [中图分类号]　R733.4 [文献标志码] A [文章编号]　1000-7431 (2014) 08-0750-04 Castleman’s disease of hyaline-vascular type confined to the kidney: a report of two cases and review of literature ZHU Xi, TIAN Ye, HAO Gang-yue, XIAO Jing, LU Yi Department of Urology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China [A BSTRACT]　Objective: To improve the knowledge of diagnosis and treatment of Castleman’s disease confined to the kidney. Methods: Two cases of Castleman’s disease of the hyaline-vascular type confined to the kidney were discussed in combination with a review of related literature, including the onset, characteristics, imaging, pathology, treatment and prognosis. Case 1 was admitted to hospital because of a mass in left kidney for 2 months. The B-ultrasound showed it was a hypoechoic mass in left kidney without blood flow. Computed tomography (CT) scan showed a high density mass in renal pelvis, with slight enhancement after contrast media injection. Case 2 was admitted to