头颈部Castleman病10例临床病理分析

中国口腔颌面外科杂志 ›› 2016, Vol. 14 ›› Issue (3): 257-262.

头颈部Castleman病10例临床病理分析

程嘉, 周洁, 王国栋, 黄建涛, 陈潇卿, 吴洋, 刘渊, 姜蕾^*, 赵云富^*

第二军医大学附属长征医院口腔科,上海 200003

收稿日期:2015-09-22 出版日期:2016-06-20 发布日期:2016-07-04
通讯作者: 姜蕾, E-mail:ajianglei@yeah.net;
作者简介:程嘉(1988-),女,在读硕士研究生,E-mail:308360647@qq.com;周洁(1962-),女,副主任医师,E-mail:lztu@hotmail.com。#并列第一作者
基金资助:
上海市卫生局青年科研基金（2011Y52）

Castleman’s disease of the head and neck: a clinicopathologic study of 10 cases

CHEN Jia, ZHOU Jie, WANG Guo-dong, HUANG Jian-tao, CHEN Xiao-qing, WU Yang, LIU Yuan, JIANG Lei, ZHAO Yun-fu

Department of Stomatology, Chang Zheng Hospital, Second Military Medical University. Shanghai 200003, China)

Received:2015-09-22 Online:2016-06-20 Published:2016-07-04

摘要/Abstract

摘要： 目的总结头颈部Castleman病（Castleman's disease,CD）的临床病理表现、诊断、治疗及预后特点。方法对1998年1月—2015年9月就诊于第二军医大学附属长征医院口腔科的10例CD患者的临床资料进行回顾分析,对组织病理切片进行光镜观察和免疫组织化学检测。结果10例患者中,男6例、女4例,中位年龄44岁（19~67岁）;就诊前病程15 d~8 a不等（中位病程12个月）;位于腮腺3例、颈部7例;按组织病理分型,透明血管型6例,浆细胞型4例;按临床类型分类,局限性透明血管型CD 6例、局限性浆细胞型CD 2例、多中心CD 2例。结论CD应作为头颈部肿块的鉴别对象。无论是透明血管型CD,还是浆细胞型CD,明确诊断后均应作长期观察,以及时发现疾病复发、恶变征兆。

关键词: Castleman病, 头颈部, 临床病理学

Abstract: PURPOSE: To summarize the clinicopathological features, diagnosis, treatment strategies and prognosis of Castleman's disease (CD) in the head and neck. METHODS: We analyzed 10 cases of CD in the head and neck region with pathological diagnosis of CD treated between January 1998 and September 2015. Immunohistochemical staining was performed on paraffin-embedded tissues. RESULTS: The studied subjects consisted of 6 males and 4 females. The median age was 44 years old(range from 19 to 67 years old). The course of disease ranged from 15 days to 8 years with a median of 12 months. The most common sign was an asymptomatic mass in head or neck region. The primary lesions included the parotid region in 3 patients and neck in 7 patients. According to histopathological subclassification, 6 cases were hyaline-vascular type (HVT) and 4 cases were plasma cell type (PCT). Clinically, 6 cases were localized HVT-CD, 2 cases were localized PCT-CD and 2 were multicentric CD. CONCLUSIONS: CD should be considered in the differential diagnosis of cervical nodal enlargements. Overgrowth of follicular dendritic cells in the hyaline vascular type of CD might represent a precursor of follicular dendritic cell sarcoma.

Key words: Castleman disease, Head and neck, Clinical pathology

中图分类号:

R739.8

程嘉, 周洁, 王国栋, 黄建涛, 陈潇卿, 吴洋, 刘渊, 姜蕾, 赵云富. 头颈部Castleman病10例临床病理分析[J]. 中国口腔颌面外科杂志, 2016, 14(3): 257-262.

CHEN Jia, ZHOU Jie, WANG Guo-dong, HUANG Jian-tao, CHEN Xiao-qing, WU Yang, LIU Yuan, JIANG Lei, ZHAO Yun-fu. Castleman’s disease of the head and neck: a clinicopathologic study of 10 cases[J]. China J Oral Maxillofac Surg, 2016, 14(3): 257-262.

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