Castleman病的CT表现（附9例报告）

目的 分析Castleman病的CT表现,提高对其的认识. 资料与方法 回顾性分析9例经手术病理证实的Castleman病患者CT表现,总结其特征. 结果 9例中5例位于纵隔和右肺门,左颈部和腹膜后各2例.9例中局限型8例,弥漫型1例.局限型8例病理诊断均为透明血管型,CT平扫与肌肉相比呈等密度;动态增强CT扫描,多数肿块动脉期明显强化,在延迟期均表现为持续强化,强化程度接近大动脉.弥漫型1例为浆细胞型,表现为腹膜后多个软组织结节,轮廓光整,轻度强化. 结论 Castleman病的CT表现与组织病理学密切相关,局限透明血管型CT表现具有一定特征性;弥漫浆细胞型无特征性影像学表现,确诊依赖组织病理学.     

多中心型Castleman病的研究进展

Castleman病,又称为巨大淋巴结增生症或者血管淋巴性滤泡组织增生,该病为一种少见的异质性淋巴组织增生性疾病.目前,对Castleman病的文献报道多为小样本量或者个案研究,而研究主要集中于多中心型Castleman病(MCD)的发病机制及其治疗方面,并且取得了一些新的进展.笔者拟就MCD的病因及发病机制、临床表现、诊断及治疗等方面的研究进展进行综述.     

CASTLEMAN'S DISEASE OF THE ABDOMINAL REGION IN ADOLESCENT

Objective To describe the CT features of abdominal Castleman＇s disease（CD）in adolescent.Methods Abdomen CT of four adolescents ranging in age from 7 years to 17 years diagnosed as abdominal region CD were reviewed.One case was retroperitoneal CD; one case was lesser omentum CD; and the other two cases were mesenteric CD.Three of four cases underwent post enhancement,and one case was only done no contrast CT as the reason of media hypersusceptibility.One case underwent needle biopsy.Three cases were removed by surgical resection.Results Isolated or multiple well-defined homogenous masses with homogenously enhanced after underwent enhancement was the common finding in these four cases.Conclusion Recognition of the CT features and highlights the histological specimen of CD is helpful to diagnose CD.     

Castleman病8例临床分析

目的探讨Castleman病的临床特征、实验室检查特点及治疗方案。方法回顾性分析8例Castleman病的临床表现、实验室检查、治疗及疗效评价。结果 8例患者中4例首发症状有乏力,3例有低蛋白血症,3例有蛋白尿或者肾损害,2例有感染,1例有肌损害。3例确诊为透明血管型,3例为浆细胞型,2例为混合细胞型。病理学提示淋巴结结构保持完整,滤泡增生明显,血管增生。结论 Castleman病临床表现无特异性,其诊断和分型主要依靠组织病理学,手术、化疗、放疗及生物治疗等多种方法可应用于该病的治疗。     

Laparoscopic approach of Castleman's disease in the pararenal retroperitoneum: report of two cases

Castleman's disease (CD) is a benign lymphoid neoplasm characterized by massive proliferation of the lymphoid tissue due to an uncertain cause.1 Two clinical types (localized, multicentric) have been described with three histological variants (hyaline-vascular, plasma cell and mixed type). The expected localization is mediastinum and rarely pararenal retroperitoneum.     

疑似肾盂癌合并castleman病1例并文献复习

目的：提高对Castleman病（Castleman＇s disease,CD）累及肾脏的临床特征认识。方法：结合1例疑似肾盂癌合并Castleman病临床资料进行文献复习。结果：患者,女,70岁,因发热4天住院,入院诊断：左肾盂占位。行手术治疗,术后确诊Castleman病。结论：Castleman病引起肾脏损害较少见,且临床表现不典型,如遇此种类似病例尽早行肿大淋巴结活检,以期尽早帮助明确诊断。     

Imaging findings of Castleman disease of the abdomen and pelvis

BACKGROUND: The purpose of this study was to analyze the characteristic features of Castleman disease in the abdomen and pelvis as suggested by imaging findings in order to deepen the recognition and understanding of this rare disease. METHODS: A group of ten patients with pathologically proven Castleman disease in the abdomen (n = 9) and pelvis (n = 1) were included in this study. Patients were 18 approximately 56-year-old (mean = 40); seven of them were men and three were women. Imaging findings (CT&MRI, n = 4; only CT, n = 4; only MRI, n = 2) were retrospectively reviewed and correlated with clinical and pathologic findings. RESULTS: The lesions were divided into those with localized Castleman (n = 9) and disseminated Castleman (n = 1). The pathologic subtype of all nine cases of localized disease was hyaline vascular with six patients showing a solitary mass and three having a single dominant mass surrounded by small satellite nodules. On nonenhanced CT images, the lesions were manifested as homogeneous masses of soft tissue attenuation, which was isoattenuated relative to normal muscle. On MRI, the lesions were isointense or slightly hypointense compared with that of normal muscle on T1-weighted images and hyperintense on T2-weighted images. After intravenous injection of contrast media, most of the masses (7/9) showed marked enhancement and slow washout with the degree of enhancement approaching that of the large arteries. And in the interior of four cases of larger masses (>5 cm) was observed fissured and radial patterns in both low-density area on CT and low-signal area on MRI. These patterns were pathologically proved to be fibrous. The pathological subtype of a sole disseminated case was plasma-cell type, where imaging findings showed a lining of well defined, sharply enhanced soft-tissue nodules in retroperitoneal zone. CONCLUSION: Imaging findings of Castleman disease in the abdomen and pelvis are closely related to pathological type diagnosed. The characteristic features of localized and hyaline vascular type of Castleman disease include a solitary mass or a dominant mass surrounded with small satellite nodules, and high enhancement and slow washout with the degree of enhancement approaches that of large arteries. The presence of central areas of fibrosis of the larger tumors is one of the characteristic features of this disease.     

Castleman disease: CT and MR imaging features of a retroperitoneal location in association with paraneoplastic pemphigus

We describe the CT and MRI features of a case of Castleman disease which was unusual by both its retroperitoneal location and its association with paraneoplastic pemphigus. Received: 9 July 1998; Revision received: 16 November 1998; Accepted: 12 January 1999