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中华诊断学电子杂志 ›› 2017, Vol. 05 ›› Issue (01) : 55 -58. doi: 10.3877/cma.j.issn.2095-655X.2017.01.015

所属专题: 文献

临床研究

多中心Castleman病的临床诊断学特征并文献复习
宋敏1, 苏娜2, 刘艳2, 蒋胜华2, 姜鲁宁2,()   
  1. 1. 272067 济宁医学院
    2. 272029 济宁医学院附属医院呼吸内科
  • 收稿日期:2016-12-19 出版日期:2017-02-26
  • 通信作者: 姜鲁宁
  • 基金资助:
    山东省自然科学基金资助项目(ZR2012HL36); 山东省医药卫生科技发展计划项目(2016WS0176)

Diagnosis and literature review of multicentric castleman disease

Min Song1, Na Su2, Yan Liu2, Shenghua Jiang2, Luning Jiang2,()   

  1. 1. Graduate School, Jining Medical University, Jining 272067, China
    2. Department of Respiration, Affiliated Hospital of Jining Medical University, Jining 272029, China
  • Received:2016-12-19 Published:2017-02-26
  • Corresponding author: Luning Jiang
  • About author:
    Corresponding author: Jiang Luning, Email:
引用本文:

宋敏, 苏娜, 刘艳, 蒋胜华, 姜鲁宁. 多中心Castleman病的临床诊断学特征并文献复习[J]. 中华诊断学电子杂志, 2017, 05(01): 55-58.

Min Song, Na Su, Yan Liu, Shenghua Jiang, Luning Jiang. Diagnosis and literature review of multicentric castleman disease[J]. Chinese Journal of Diagnostics(Electronic Edition), 2017, 05(01): 55-58.

目的

探讨多中心型Castleman病(MCD)的临床诊断学特征。

方法

回顾性分析2016年5月29日济宁医学院附属医院呼吸内科收治的1例混合型MCD患者的临床特点,并复习相关文献,总结MCD患者的临床诊断学特点。

结果

患者因发热、乏力10余天入院,行正电子发射计算机断层显像(PET/CT)提示双侧颈部、锁骨上区、纵隔内、双侧腋下、腹膜后、腹腔、盆腔、双侧腹股沟多发淋巴结肿大,代谢不同程度增高,双侧胸腔积液并双肺下叶膨胀不全,盆腔积液,全身骨弥漫性代谢增高,符合Castleman病的PET/CT表现。行颈部淋巴结活检,病理学示混合型CD。免疫组化:CD3T淋巴细胞(+),CD20B淋巴细胞(+),CD21滤泡FDC呈网状(+),Ki-67滤泡阳性细胞数比例高于75%,滤泡间区阳性细胞数5%~10%,CD34血管(+)。

结论

本病影像学表现有一定特征,早期行活检组织病理学检查有助于诊断。

Objective

To explore the diagnostic features of multicentric castleman disease(MCD).

Methods

The clinical features of a MCD patient, who was diagnosed in respiratory department of the Affiliated Hospital of Jining Medical University in 2016 were analyzed.Relevant literatures were reviewed and characteristics of clinical diagnosis of MCD were summarized.

Results

A 29 year old woman was hospitalized because of fever, fatigue over ten days.Positron emission tomography computed tomography(PET/CT) showed bilateral neck, clavicle, mediastinal, bilateral axillary, retroperitoneal, abdominal, pelvic, bilateral inguinal nodes enlargement and metabolism were increased in different degrees.Bilateral pleural effusion and atelectasis, pelvic effusion bone metabolism were increased, the features were in accordance with the PET/CT manifestation of CD.Mix-MCD was diagnosed by cervical lymph node biopsy.Immunohistochemical showed CD3T lymphocytes (+ ), CD20B lymphocytes (+ ), CD21 follicular FDC showing reticular (+ ), the percentage of Ki-67 positive cells was higher than 75%, the percentage of positive cells in the follicular area was 5%~10%, CD34 blood vessels (+ ).

Conclusion

The imaging manifestations of the disease manifests certain characteristics, early biopsyhistopathological examination is helpful for diagnosis.

图1 Castleman病患者化疗3周期后颈部及盆腔CT检查图像。a图示双侧颈部软组织间隙散在小淋巴结;b图示双侧腹股沟区散在小淋巴结
图2 Castleman病患者右侧颈部淋巴结活检病理学图像(HE ×40)。淋巴结活检呈混合型CD改变
[1]
Castleman B,Towne VW.Case records of the Massachusetts General Hospital:case No.40231[J]. N Engl J Med, 1954, 250(23): 1001-1005.
[2]
Gaba AR,Stein RS,Sweet DL, et al.Multicentric giant lymph node hyperplasia[J]. Variakojis D Am J Clin Pathol, 1978, 69(1): 86-90.
[3]
Munshi N,Mehra M,Van de Velde H, et al. Use of a claims database to characterize and estimate the incidence of Castleman's disease[J]. Leuk Lymphoma, 2015, 56(5): 1252-1260.
[4]
Seo S,Yoo C,Yoon DH, et al.Clinical features and outcomes in patients with human immunodeficiency virus-negative, multicentric Castleman's disease:a single medical center experence[J]. Blood Res, 2014, 49(4): 253-258.
[5]
Kawabata H,Kadowaki N,Nishikori M, et al.Clinical features and treatment of multicentric castleman's disease:a retrospective study of 21 Japanese patients at a single institute[J]. J Clin Exp Hematop, 2013, 53(1): 69-77.
[6]
Hill AJ,Tirumani SH,Rosenthal MH, et al.Multimodality imaging and clinical features in Castleman disease:single institute experience in 30 patients[J]. Br J Radiol, 2015, 88(1049): 20140670.
[7]
Dispenzieri A,Armitage JO,Loe MJ, et al.The Clinical Spectrum of Castleman's Disease[J]. Am J Hematol, 2012, 87(11): 997-1002.
[8]
Tedesco S,Postacchini L,Manfredi L, et al.Successful treatment of a caucasion case of multifocal castleman disease with TAFRO syndrome with a pathophysiology targeted therapy-a case report[J]. Exp Hematol Oncol, 2015, 4(1): 3.
[9]
Fajgenbaum DC,van Rhee F,Nabel CS.HHV-8-negative, Idiopathic multicentric Castleman disease:novel insights Into biology, pathogenesis, and therapy[J]. Blood, 2014, 123(19): 2924-2933.
[10]
Casper C,Teltsch DY,Robinson D Jr, et al.Clinical characteristics and healthcare utilization of patients with multicentric Castleman disease[J]. Br J Haematol, 2015, 168(1): 82-93.
[11]
Robinson D Jr,Reynolds M,Casper C, et al.Clinical epidemiology and treatment patterns of patients with multicentric Castleman disease:results from two US treatment centres[J]. Br J Haematol, 2014, 165(1): 39-48.
[12]
Talat N,Belgaumkar AP,Schulte KM. Surgery in Castleman's disease: a systematic review of 404 published cases[J]. Ann Surg, 2012, 255(4): 677-684.
[13]
Melkundi RS,Prasad KC,Jalisatoi RR, et al.Uncentric castleman disease:unusual disorder of the neck a case review[J]. J Clin Diagn Res, 2015, 9(4): MD03-MD04.
[14]
权春姬. 细针穿刺误诊Castleman病一例[J]. 实用医技杂志, 2013, 20(11): 1263.
[15]
张路,李剑. Castleman病发病机制研究进展[J]. 中国医学科学院院报, 2016, 38(1): 118-121.
[16]
Rokx C,Rijinders BJ,van laar JA. Treatment of multicentric castleman’s disease in HIV infected and uninfected patients:a systematic review[J]. Neth J Med, 2015, 73(5): 202-210.
[17]
Zhu SH,Yu YH,Zhang Y, et al.Clinical features and outcome of patients with HIV-negative multicentric castleman′s disease treated with combination chemotherapy:a report on 10 patients[J]. Med Oncol, 2013, 30(1): 492.
[18]
杨志寅. 医学不是神[J/CD]. 中华诊断学电子杂志, 2016, 4(4): 217-221.
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