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目的:报告1例肾癌合并肾周Castleman病(Castleman disease,CD)患者的诊疗经过,结合文献复习探讨诊治方法。方法:结合文献复习,回顾性分析1例肾癌合并肾周CD患者的临床特征、实验室检查、影像学检查、手术方式、病理特点及随访情况。结果:该患者根据术前影像学检查考虑右肾癌并淋巴结转移,行后腹腔镜下右肾癌根治术,病理确诊为右肾透明细胞癌合并肾周透明血管型CD,随访6个月未见复发及转移。Castleman病为临床罕见疾病,无特征性临床表现,实验室,影像学上难以与原发或转移性肿瘤病灶鉴别,确诊主要依据术后病理。结论:CD是临床罕见疾病,但肾周血供丰富、不均匀强化的淋巴结病变均应考虑CD可能,提高对CD的认识水平有助于早期诊断并选择合适的治疗方法,肾癌合并肾周肿大的淋巴结不应该仅考虑恶性改变。
Objective: To report the diagnosis and treatment of 1 case of renal cell carcinoma with Castleman’s disease (Castleman disease, CD). Methods: According to the literature review, the clinical features, laboratory tests, imaging examination, operation methods, pathological features and follow-up of 1 patient with renal cell carcinoma and perirenal CD were analyzed retrospectively. Results: According to the preoperative imaging examination, the patient considered right renal cell carcinoma and lymph node metastasis, and underwent laparoscopic radical nephrectomy. The pathological diagnosis of clear cell carcinoma of right kidney combined with clear perirenal vascular CD was followed up for 6 months See recurrence and metastasis. Castleman disease is a rare clinical disease, no clinical manifestations, laboratory, imaging and primary or metastatic tumor focus is difficult to identify, the diagnosis is mainly based on postoperative pathology. Conclusions: CD is a rare clinical disease. However, it is necessary to consider CD in patients with lymph node lesions with rich peritumor and nonuniformity of renal function. To improve the level of understanding of CD is helpful for early diagnosis and selection of appropriate treatment. Swollen lymph nodes should not only consider malignant changes.