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目的探讨腹部Castleman病(CD)的临床和病理特征,旨在提高对该病的诊断、治疗水平。方法检索中国生物医学文献数据库光盘1995-2003,对8篇文献中共16例腹部CD病例进行统计分析。结果局灶性CD(LCD)9例,腹块、腹痛为主要表现,少有或仅有轻度系统症状;病理分型透明血管型4例,混合型3例,浆细胞型2例;局部手术切除预后良好。多中心CD(MCD)7例,腹痛为最常见症状(66.7%),85.7%有系统症状,易误诊为淋巴瘤和腹腔淋巴结核;病理分型浆细胞型4例,混合型2例,透明血管型1例;广泛手术切除仍易复发。结论腹部CD临床表现缺乏特异性,剖腹探查是明确诊断的主要手段。MCD可予化疗和/或放疗。密切随访可早期发现复发和继发的恶性病变。
Objective To investigate the clinical and pathological features of Castleman’s disease (CD) in the abdomen and to improve the diagnosis and treatment of this disease. Methods The Chinese Biomedical Literature Database CD-ROM was searched from 1995 to 2003, and 16 cases of CD in abdomen of 8 literatures were analyzed statistically. Results There were 9 cases of focal CD (LCD), abdominal mass and abdominal pain, with few or only slight symptoms. The pathologic type of the transparent blood vessel type was 4 cases, the mixed type 3 cases and the plasma cell type 2 cases. The local Surgical resection of the prognosis is good. Seven cases of multicentric CD (MCD) had abdominal pain as the most common symptom (66.7%), 85.7% had systemic symptoms and were easily misdiagnosed as lymphomas and peritoneal lymphadenopathy. Pathologic type of plasma cell type was found in 4 cases, mixed type in 2 cases, 1 case of vascular type; a wide range of surgical resection is still easy to relapse. Conclusion Abdominal CD clinical manifestations of the lack of specificity, laparotomy is a clear diagnosis of the main means. MCD may be given chemotherapy and / or radiotherapy. Close follow-up early detection of recurrent and secondary malignant lesions.