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目的总结1例胰腺Castleman病患者的临床资料,并复习以往文献,总结该病的流行病学特点及诊治体会。方法回顾性分析2016年1月笔者所在医院收治的1例胰腺Castleman病患者的临床资料,进行文献复习及总结。结果该例患者无特殊临床表现,术前行CT检查发现胰腺占位,行手术切除,术后病理学诊断为胰腺Castleman病。术后1个月复查CT未见肿瘤复发及转移,已获访6个月,患者恢复良好。经查阅文献,共检索出胰腺Castleman病32例,男11例,女21例;年龄23~74岁,平均年龄为46岁;临床表现仅为腹部疼痛7例,腹痛伴发热1例,腹痛伴面部、双下肢水肿1例,腹痛伴乏力1例,腹胀1例,背部疼痛1例,颈部淋巴结肿大1例,吞咽困难1例,发热、乏力、体质量下降1例,无明显临床表现17例;肿瘤位于胰腺头部9例,胰腺颈部3例,胰腺体、尾部16例,胰周4例;肿瘤直径最小1.5 cm,最大7.2 cm;病理学分型为透明血管型(hyaline vascular,HV)19例,浆细胞型(plasma cell,PC)4例,混合型(mixed/HV-PC,MV)4例,未给出明确病理分型5例。结论胰腺Castleman病是少见的淋巴组织增生性疾病,通常无特异临床表现,影像学检查也无特异性,目前仅能通过病理组织学检查确诊。胰腺Castleman病的治疗以手术为主,疗效较好。
Objective To summarize the clinical data of 1 case of Castleman Castleman’s disease and to review the literature and summarize the epidemiological characteristics and diagnosis and treatment of the disease. Methods The clinical data of 1 patient with Castleman’s disease of pancreas admitted to the hospital in January 2016 were retrospectively reviewed and reviewed. Results The patient had no special clinical manifestations. Pancreas was found preoperatively underwent CT scan. Surgical resection was performed. Postoperative pathological diagnosis was Castleman’s disease of the pancreas. One month after the operation, no recurrence and metastasis of the tumor were observed in the CT. The patients were followed up for 6 months and the patients recovered well. A total of 32 cases of Castleman’s disease of the pancreas were retrieved, including 11 males and 21 females, aged from 23 to 74 years with a mean age of 46 years. The clinical manifestations were only 7 cases of abdominal pain, 1 case of abdominal pain with fever, 1 case of abdominal pain 1 case of facial and lower extremity edema, 1 case of abdominal pain with abdominal distension, 1 case of abdominal distension, 1 case of back pain, 1 case of cervical lymph node enlargement, 1 case of dysphagia, fever, fatigue, body mass loss in 1 case, no obvious clinical manifestations 17 cases. The tumor was located in the head of pancreas in 9 cases, 3 cases of pancreas neck, 16 cases of pancreas and tail, 4 cases of pancreas. The diameter of tumor was 1.5 cm and the maximum was 7.2 cm. Pathological type was hyaline vascular HV), 4 cases of plasma cell (PC) and 4 cases of mixed / HV-PC (MV). No definite pathological type was identified in 5 cases. Conclusions Castleman’s disease of the pancreas is a rare lymphoproliferative disease and usually has no specific clinical manifestations. Imaging diagnosis is also nonspecific and currently only confirmed by histopathological examination. Castleman’s disease treatment of pancreatic surgery, better effect.