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|本期目录/Table of Contents|

 胸内Castleman病的外科治疗()

《中国胸心血管外科临床杂志》[ISSN:1007-4848/CN:51-1492/R]

期数:
2010年第17卷第3期
页码:
202-205
栏目:
临床研究论著
出版日期:
2010-06-25

文章信息/Info

Title:
 Surgical Treatment of Intrathoracic Castleman Disease
文章编号:
1007-4848（2010）03-0198-04
作者:
 陈刚 任华 郭峰 等
 中国医学科学院 北京协和医学院 北京协和医院 胸外科， 北京 100730
Author(s):
 CHEN Gang;  REN Hua;  GUO Feng;  et al .
 

Department of Thoracic Surgery，Peking Union Medical College Hospital，Chinese Academy of Medical Sciences & Peking Union Medical College，Beijing 100730，P．R．China

关键词:
 ; Castleman病;  外科治疗;  病理检查
Keywords:
 ; Castleman disease;  Surgical treatment;  Pathological examination
分类号:
R551.2
DOI:
-
文献标识码:
A
摘要:
 目的 探讨胸内Castleman病的临床病理特点及外科诊治方法。 方法 回顾性分析我科经病理检查证实的14例Castleman病患者的临床资料及诊疗情况，其中男6例，女8例；年龄17~58岁，平均年龄29岁。局限型12例，多中心型2例。所有患者均行手术切除肿物或淋巴结活组织检查；12例局限型患者行常规侧开胸及胸骨正中开胸手术11例，电视胸腔镜辅助小切口手术1例；2例多中心型患者分别行纵隔镜淋巴结活组织检查及电视胸腔镜肺结节活组织检查。 结果 无手术死亡。术后第2 d 1例患者出现憋气，行床旁支气管镜检查示：右主支气管开口局部软化塌陷，经对症处理后好转；1例肿块位于主动脉窗的患者出现一过性声音嘶哑；其余患者术后恢复顺利。 病理检查结果：透明血管型（HV）11例，浆细胞型（PC）2例，混合型（Mix）1例。术后随访13例，随访时间8~110个月，随访患者均生存，11例局限型患者无复发，2例多中心型患者病情稳定。 结论 术中冰冻病理及术后石蜡病理检查对明确Castleman病的诊断有重要意义。局限型Castleman病经手术切除后患者症状消失，治愈率高；多中心型Castleman病需进行综合治疗，密切随访。
Abstract:
 Objective To investigate the clinicopathological characteristics and surgical treatment of intrathoracic Castleman disease(CD). Methods Clinical data of 14 cases pathologically diagnosed as CD as analysed retrospectively. There were 6 males and 8 females, with an average age of 29 years(17-58). All were undergone surgical resection or biopsy. Among the 12 patients who had unicentric CD, 11 were performed open thoracotomy and lymphadenectomy with posterolateral or sternum approach, and one was treated by video assisted mini thoracotomy(VAMT). For the diagnosis of multicentric CD, one of the 2 patients had video assisted thoracic surgery(VATS) and wedge resection of the lung, and the other had video mediastinoscopy. Results No patient died perioperatively. All were successfully restored except two complications. One had dyspnea in the second postoperative day, as a result of the softening and collapse of bronchial wall in the entrance of the right main bronchus, which revealed by bedside fiberoptic bronchoscopy. One who had lymphadenopathy in the aortopulmonary window suffered from transient hoarseness after surgery. They recovered after symptomatic treatment finally. Regarding pathological classification, there were 11 cases of hyaline vascular type, 2 cases of plasma cell type and 1 case of mixed cellularity type. 13 cases were followed up for 8-110 months and longterm survive was achieved. No recurrence was observed in the 11 cases with unicentric CD and no relapse was occurred in the 2 cases with multicentric CD. Conclusion Both freezing pathology during operation and paraffin pathology postoperation are important for establishing the diagnosis. For unicentric CD, the clinical symptoms are significantly alleviated and it can be universally cured after operation. Multicentric CD needs multiple therapies after the diagnostic procedure and close follow-up.

参考文献/References

备注/Memo

备注/Memo:
更新日期/Last Update: 2010-07-06