26例胸内局限性Castleman病诊治分析

目的 探讨胸内局限性Castleman病的诊断及治疗,提高对该病的认识及诊治水平.方法 回顾性分析2010年1月至2016年12月中国医科大学附属第一医院胸外科诊治的26例胸内局限性Castleman病患者的临床资料及病理资料.结果 26例患者中男14例,女12例;中位年龄为36.5 (24.8～69.3)岁;病程中位数为2.8(0.2～7.8)个月.所有患者均行手术治疗,其中常规开胸手术16例,电视辅助胸腔镜手术10例.26例患者术后均获得随访,中位随访时间为46.6 (4.2～70.6)个月.22例病理类型为透明血管型,4例为浆细胞型.除1例浆细胞型Castleman病患者于术后42个月复发外,其余患者术后均达到持续完全缓解,复发患者行术区局部放疗后目前处于部分缓解.结论 胸内局限性Castleman病手术治疗效果良好,尤其是透明血管型术后无复发,但浆细胞型术后有复发的可能性.

Diagnosis and treatment of 26 cases of thoracic limited Castleman's disease

Objective To investigate the diagnosis and treatment of thoracic limited Castleman's disease,and to improve the understanding of the disease.Methods The clinical data and pathologic data of 26 cases of thoracic limited Castleman's disease were analyzed retrospectively from January 2010 to December 2016 in the First Hospital of China Medical University.Results Among the 26 patients,14 cases were male and 12 cases were female.The median age was 36.5 (24.8-69.3) years old.The median course of disease was 2.8 (0.2-7.8) months.All patients underwent surgical treatment,including conventional thoracotomy in 16 cases,video-assisted thoracoscopic surgery in 10 cases.All of the 26 patients were followed up for 46.6 (4.2-70.6) months.The pathological type of 22 cases was hyaline vascular type,four cases were plasma cell type.In addition to a case of plasma cell type recurring in 42 months after the surgery,the remaining patients achieved complete remission after surgery.Conclusions The surgery treatment of thoracic Iimited Castleman’s disease is effective,especially for hyaline vascular type.However,there is a possibility of recurrence after the operation for plasma cell type.