论文部分内容阅读
目的:总结Castleman病(Castlemans disease,CD)的临床特点。方法:对2003-2016年在本院诊断Castleman病的60例患者的临床资料做回顾性分析。结果:60例CD患者根临床分为局灶型(unicentric CD,UCD)和多中心型(multicentric CD,MCD),分别包括三个病理类型:透明血管型(hyaline vascular type,HV-CD)、浆细胞型(plasma cell type,PC-CD)、混合型(mixed type,Mix-CD)。37例UCD临床症状轻微,均行手术治疗为主,预后较好。23例MCD临床症状复杂,其中8例有水肿或胸、腹水,6例体重减轻或乏力,5例出现咳嗽、咳痰,4例有心悸、气促,4例有口腔溃疡,3例有皮肤溃疡,3例有发热,3例有出血症状,2例出现肢体、皮肤麻木,盗汗,消化道症状和肝脾肿大各1例;实验室检查可见免疫球蛋白升高、自身抗体以及类风湿因子升高、急性期反应物升高、低白蛋白血症、贫血等异常;需手术和药物综合治疗,预后较差。结论:Castleman病可通过病理活检确诊,UCD临床症状轻微,手术治疗效果好,MCD临床症状复杂,需综合治疗,预后相对较差。
Objective: To summarize the clinical features of Castleman disease (CD). Methods: The clinical data of 60 patients with Castleman’s disease diagnosed in our hospital from 2003 to 2016 were analyzed retrospectively. Results: Sixty patients with CD were divided into three groups: unicentric CD (UCD) and multicentric CD (MCD). The pathological types included hyaline vascular type (HV-CD) Plasma cell type (PC-CD), mixed type (Mix-CD). 37 cases of UCD clinical symptoms were minor, were treated with surgery, the prognosis is good. Twenty-three patients had complicated clinical symptoms, of which 8 had edema or thoracic and ascitic fluid, 6 had weight loss or fatigue, 5 had cough and expectoration, 4 had palpitations, 4 had oral ulcers and 3 had skin ulcers Ulcer, 3 cases of fever, 3 cases of bleeding, 2 cases of limbs, skin numbness, night sweats, gastrointestinal symptoms and hepatosplenomegaly in 1 case; laboratory examination showed elevated immunoglobulin, autoantibodies and rheumatoid Elevated factors, acute phase reactants, hypoalbuminemia, anemia and other anomalies; need surgery and drug treatment, the prognosis is poor. Conclusions: Castleman’s disease can be diagnosed by pathological biopsy. The clinical symptoms of UCD are slight, the effect of surgery is good, the clinical symptoms of MCD are complex, and the comprehensive treatment is needed. The prognosis is relatively poor.