Castleman病的临床病理诊断与治疗体会.doc

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1、Castleman病的临床病理诊断与治疗体会作者：刘虎，彭，燕,王志华，徐，兵单位：合肥安徽省立医院小儿外科【摘要】目的探讨Castleman病的临床病理特点及治疗体会。方法通过常规纽织病理和免疫纽.织化学等方法观察5例Castleman病并结合相关文献进行分析。结果该病女性多于男性，5例Castleman病中4例为透明血管型，表现为淋巴滤泡增生，滤泡生发中心变小，套区增生的淋巴细胞围绕滤泡生发中心呈同心圆状，形成特征性的"洋葱"样同心圆结构;1例浆细胞型滤泡间大量的成熟浆细胞增生伴淋巴窦消失，滤泡内的毛细血管穿入，"洋葱"样改变不明显及滤泡间吋见无

2、定羽的嗜酸性物质沉积。结论Castleman病是一种特殊类型的淋巴结増生性疾病，可发生于任何年龄;其病因可能与人疱疹病毒8(HHV-8)有关，该病的诊断和分型主要依靠纽织病理学;治疗方面：手术切除是首选，辅以化疗、放疗和生物治疗等多种方法联合应用，有助于控制本病的发展。【关键词】Castleman病;病理诊断;治疗ClinicopathologicaldiagnosisandtreatmentexperiencewithCastlemansdiseaseLiuHu,PengYan、WangZhihua,etalDepartmentofPathology,AnhuiProvincialHos

3、pital，Hefei230001［Abstract］ObjectiveTostudytheclinicopathologicalcharacteristicsandtreatmentofCastlemandisease.MethodsFrom2000to2008fivecasesofCastlemandiseasewereobservedandanalyzedwithliteraturereview,accordingtohistopathologicalcharacteristicsandimmunohistochemicalmethod.ResultsThefemalespatien

4、twasmorethanmales,4caseswereofhyaline-vasculartypewhichshowedlymphoidfollicularhyperplasiaandsmallgenminalcenter.Lymphocytecellsinmantlezonewereconcentriccirclesaroundgenminalcenter.,forming"characteristiconion"structure・Therestonecasewasplasmacelltypethatcharacterizedbydifftuseplamascel

5、lproliferationintheinterfolIiculartissue・Thefollecleswereinconspicuousorabsent;instead,oneoftenencouteredinthecenterofthesefolliclesadepositionofanamorphousacidophilicmaterial.Inclinicalpractice,localtypewasmuchmorethanmulticentrictype・Generally,thisdiseasewasgoodprognosis・ConclusionCastlemanDisea

6、seisaspecialgiantlymphnodehyperplsia,whichcanoccuratanyage.Causeofdiseasewasassociatedwithherpesvirus8(HHV-8)probably.Thediagnosisandpathologicaltypewerebasedonitshistopathologicalcharacteristics・Surgicaloperationisthefirstchoice,chemotherapyandradiotherapyandbiotherapymaycontributetocontrolthedis

7、ease.［Keywords］Castlemandisease;Pathologicaldiagnosis;TreatmentCastleman病(CD)又称血管滤泡性淋巴纟I［织增生，是一种不明原因的淋巴结增生性疾病，1956年li

8、Cas(lnw】［l］首先描述。纽织病理学分为透明血管型、浆细胞型和混合型;临床上又可分为局限型和多中心型两种类型［2］。该病最曲发生的部位是胸内，特别是纵隔区域。临床发病罕见，该病的诊断