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目的分析Castleman病(CD)的临床特征及疗效。方法选取2010年1月—2014年10月泸州医学院附属医院血液内科收治的CD患者8例,回顾性分析其临床特征及疗效。结果 8例患者病理分型为透明血管型(HV-CD)4例,浆细胞型(PC-CD)4例;临床分型为局灶型(LCD)3例,多中心型(MCD)5例。LCD患者中1例临床表现为颈部淋巴结无痛性肿大,2例胸部CT提示为胸腔内前纵隔淋巴结肿大,临床表现为胸闷、咳嗽,无其他全身症状表现;MCD患者均有不同程度的发热、盗汗、乏力、体质量下降等全身症状,部分患者伴有肝脾大、不同程度水肿、皮肤改变等。LCD患者实验室检查结果显示淋巴结肿大;MCD患者均伴不同程度贫血、红细胞沉降率增快、低蛋白血症、肝功能异常、乳酸脱氢酶增高等。LCD患者均行手术切除治疗;MCD患者予以CHOP或COP方案化疗,治疗后MVD患者完全缓解(CR)3例,部分缓解(PR)1例,疾病稳定(SD)1例。结论 CD患者的临床表现具有异质性,诊断主要依靠组织病理学检查,联合化疗是一种有效的治疗手段。
Objective To analyze the clinical characteristics and curative effect of Castleman’s disease (CD). Methods From January 2010 to October 2014, eight patients with CD were admitted to Department of Hematology, Affiliated Hospital of Luzhou Medical College. The clinical features and therapeutic effects were retrospectively analyzed. Results Eight cases were pathologically classified into 4 types of clear-vessel type (HV-CD) and 4 types of plasma cell type (PC-CD). The clinical type was focal type (LCD) example. The clinical manifestations of 1 patient with LCD were painless swelling of the neck lymph nodes, 2 chest CT findings were anterior thoracic mediastinal lymph nodes, clinical manifestations of chest tightness, cough, no other systemic symptoms; MCD patients have varying degrees Fever, night sweats, fatigue, decreased body mass and other systemic symptoms, some patients accompanied by hepatosplenomegaly, varying degrees of edema, skin changes. LCD patients laboratory test results showed lymph nodes; MCD patients with varying degrees of anemia, erythrocyte sedimentation rate, hypoproteinemia, abnormal liver function, increased lactate dehydrogenase. LCD patients underwent surgical resection. MCD patients underwent CHOP or COP regimen chemotherapy. Three patients with complete remission (MALT), one with partial remission (PR) and one with stable disease (SD) after MVD treatment. Conclusion The clinical manifestations of patients with CD are heterogeneous, the diagnosis depends mainly on histopathological examination, combined with chemotherapy is an effective treatment.