特发性多中心型Castleman病的诊断学特征并文献复习

doi:10.3877/cma.j.issn.2095-655X.2022.01.013

中华诊断学电子杂志 ›› 2022, Vol. 10 ›› Issue (01) : 63 -66. doi: 10.3877/cma.j.issn.2095-655X.2022.01.013

病例诊断思维

特发性多中心型Castleman病的诊断学特征并文献复习

杜鹏宇¹, 朱红红²^,^†(

), 孙冰³, 冉启玉¹, 孔蕾¹

^1. 272013　济宁医学院临床医学院
^2. 272029　济宁医学院附属医院急诊科
^3. 272013　济宁医学院中西医结合学院

收稿日期:2021-10-16 出版日期:2022-02-26
通信作者: 朱红红

Diagnostic features of idiopathic multicentric Castleman disease and literature review

Pengyu Du¹, Honghong Zhu²^,^†(), Bing Sun³, Qiyu Ran¹, Lei Kong¹

^1. Clinical Medical College, Jining Medical University, Jining 272013, China
^2. Department of Emergency, Affiliated Hospital of Jining Medical University, Jining 272029, China
^3. College of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining 272013, China

Received:2021-10-16 Published:2022-02-26
Corresponding author: Honghong Zhu

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目的

探讨特发性多中心型Castleman病的诊断学特征。

方法

回顾性分析2020年6月26日济宁医学院附属医院急诊科收治的1例特发性多中心型Castleman病患者的临床资料，并复习相关文献。

结果

患者31岁，女性，因"发热1周"入院，伴乏力、咳嗽、腹胀等。体检多发淋巴结肿大；双下肺呼吸音低，叩诊浊音。胸部CT提示大量胸腔积液；给予抗感染治疗效果差。人类疱疹病毒8型(HHV-8)DNA定量检测在正常范围，人类免疫缺陷病毒(HIV)阴性。左侧颈部淋巴结活检病理学检查提示淋巴组织反应性增生，形态学呈Castleman病透明血管型改变，确诊为特发性多中心型Castleman病。

结论

及早完善HHV-8 DNA定量检测、免疫学相关指标、骨髓穿刺活检及淋巴结病理学检查等，有助于对Castleman病早期诊断和分型。

关键词: Castleman病, 特发性, 多中心, 诊断

Objective

To explore the diagnostic features of idiopathic multicentric Castleman disease.

Methods

The clinical data of a patient with idiopathic multicentric Castleman disease admitted to the emergency department of the Affiliated Hospital of Jining Medical University on June 26, 2020 was retrospectively analyzed, and relevant literatures were reviewed.

Results

The patient was a 31-year-old young female who was admitted to the hospital for " fever for 1 week" , accompanied by fatigue, cough, and abdominal distension. Physical examination showed multiple lymph node enlargement, low breath sounds in both lower lungs, and dull percussion note. Chest CT showed a large amount of pleural effusion, and anti-infective treatment was not effective.Human herpesvirus-8 (HHV-8) DNA quantitative detection was in the normal range, and human immunodeficiency virus (HIV) negative. The pathological examination of the left cervical lymph node biopsy showed reactive hyperplasia of lymphatic tissue, and the morphology showed the hyaline vascular change of Castleman′s disease. The patient was diagnosed with idiopathic polycentric Castleman′s disease.

Conclusion

Early improvement of HHV-8 DNA quantitative detection, immunological indicators, bone marrow biopsy and lymph node pathological examination are helpful for early diagnosis and typing of Castleman′s disease.

Key words: Castleman disease, Idiopathic, Multicenter, Diagnosis

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