【作者】 王硕；

【导师】 周建英；

【作者基本信息】 浙江大学 ， 呼吸内科， 2008， 硕士

【摘要】 【目的】提高对少见的胸部受累的多中心性Castleman病的认识,减少误诊,增加生存期。【方法】回顾分析5例胸部受累的多中心性Castleman病,讨论其病因病理、临床表现、影像学、鉴别诊断、治疗及预后。【结果】胸部受累的多中心性Castleman病临床表现各异,缺乏特异性,外周淋巴结多处肿大,伴多系统损害,多为浆细胞型,病理学表现为淋巴滤泡增生伴大量浆细胞浸润,影像学表现为肺门纵隔多组淋巴结肿大、淋巴细胞性间质性肺炎和胸腔积液,激素或化疗部分缓解。【结论】胸部受累的多中心性Castleman病临床表现多样,易误诊,早期多次、多部位外周淋巴结活检和肺穿刺活检病理检查对早期诊断尤为重要。根据临床和组织病理学分类,给予合适的治疗方案,能达到有效的治疗效果。更多还原

【Abstract】 [Objective] To enhance the understanding about the rare chest involved multicentric Castleman’s disease(MCD), decrease misdiagnosis and increase life span.[Methods] Clinical features and related information Of 5 cases of MCD were retrospectively analyzed,and clinical manifestation, imageology, pathology, differential diagnosis, therapeutics and prognosis have been discussed.[Results] There were a variety of clinical situations of the 5 cases ,with a lack of specificity.Multicentric Castleman’s disease has a more aggressive clinical course with diffuse lymph node enlargement and systemic illness. Most were the plasma-cell type,and Pathology shows lymph follicle hyperplasia with a lot of plasma cells infiltration.The chest imaging showed hilar as well as mediastinal lymphadenectasis, lymphocytic interstitial pneumonitis and pleural effusion. Treatment with corticosteroid and chemotherapy can achieve partial remission. [Conclusions] Chest involved multicentric Castleman’s disease has complicated clinical manifestations and is difficult to diagnose.Early, repeated and multi-location biopsies on peripheral lymphonodes and lung biopsy is important for early diagnosis. An optimal curative effect can be achieved with a suitable therapeutic option, based on histopathology and clinical classification.更多还原