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目的:探讨腹膜后局限性Castleman’s病的临床特点及治疗策略,提高对该疾病的诊治水平。方法:回顾性分析2002年1月至2016年12月天津医科大学肿瘤医院收治的18例腹膜后局限性Castleman’s病患者的临床资料,所有组织标本均经病理确诊为Castleman’s病,16例为透明血管型,2例为混合型。分析其人口学特点、临床表现、病理、治疗和预后特征。结果:18例患者中男性4例、女性14例,平均年龄为44.1(24~70)岁。肿瘤位于肾脏1例,肾上腺区域8例,肾上腺外腹膜后9例。具有临床不典型腹痛症状7例,中度贫血患者1例。患者均行手术治疗,手术时间平均为153.3(60~260)min,术中出血量为447.2(10~3 000)mL;2例患者术后输血,1例术后出现尿瘘并发症,保守治疗后好转。中位随访时间为25个月,1例患者术后2年肿瘤复发死亡。结论:腹膜后局限性Castleman’s病临床罕见,术前诊断困难,确诊依赖于病理检查。目前手术切除为主要治疗方法,预后较好。
Objective: To investigate the clinical features and treatment strategies of Castleman’s disease with retroperitoneal confinement and to improve the diagnosis and treatment of this disease. Methods: The clinical data of 18 patients with localized Castleman’s disease after retroperitoneal treatment admitted to Tumor Hospital of Tianjin Medical University from January 2002 to December 2016 were retrospectively analyzed. All the tissue samples were pathologically diagnosed as Castleman’s disease and 16 of them were clear vessels Type, two cases of mixed type. Analysis of its demographic characteristics, clinical manifestations, pathology, treatment and prognostic characteristics. Results: Among the 18 patients, 4 were males and 14 females, with an average age of 44.1 (24-70) years. The tumor was located in the kidney in 1 case, in the adrenal region in 8 cases, and in the adrenal outside the peritoneum in 9 cases. With clinical symptoms of atypical abdominal pain in 7 cases, 1 case of moderate anemia. The patients underwent surgery, with an average operation time of 153.3 (60-260) min and an intraoperative blood loss of 447.2 (10-3000) mL. Two patients had postoperative blood transfusions, 1 postoperative complications of urinary fistula, and conservative treatment After the improvement. The median follow-up time was 25 months, and 1 patient died of tumor recurrence 2 years after surgery. CONCLUSIONS: Castleman’s disease, a localized retroperitoneal disease, is clinically rare and difficult to diagnose before surgery. Diagnosis depends on pathological examination. The current surgical removal of the main treatment, the prognosis is good.