Cobzeanu M D, Rusu Danielu, Negru D, Ferariu D
Universitatea de Medicină şi Farmacie Gr.T. Popa laşi, Facultatea de Medicină, Clinica ORL1.
Rev Med Chir Soc Med Nat Iasi. 2005 Jul-Sep;109(3):567-72.
Castleman Disease is a rare disorder characterized by benign lymph node hyperplasia involving lymphatic tissue in the neck, mediastinum, abdomen, axilla. There are three types of Castleman Disease: hyalin-vascular type localized nodal involvement, asymptomatic form; plasma cell type and generalized and multicentric type.
Between 2000-2004, 5 cases with Castleman Disease hyalin-vascular type with cervical lymph node involvement were diagnosed and treated in E.N.T. Department of "St. Spiridon" Hospital Iaşi. 2 of these cases are presented: a 24 year old male and a 13 year old female were admitted with a asymptomatic neck mass with slow progressive growth. Paraclinical exams (radiology, cervical and abdominal echography, CT scanner) confirmed the lymphadenopathy and excluded another localization. Differential diagnosis included tuberculosis, metastatic lymphadenopathy, lymphoma, branchial cyst etc.
The treatment of choice was surgical excision by cervicotomy in all cases, followed by vascular proliferation and hyalinization in affected lymph nodes. Postoperative controls no revealed recurrences.
The prognosis of localized form of Castleman Disease hyalin-vascular tape is better than multicentric form surgical excision is both diagnostic and therapeutic.
卡斯特曼病是一种罕见的疾病,其特征为良性淋巴结增生,累及颈部、纵隔、腹部、腋窝的淋巴组织。卡斯特曼病有三种类型:透明血管型,表现为局限性淋巴结受累,无症状形式;浆细胞型以及弥漫性多中心型。
2000年至2004年期间,雅西“圣斯皮里东”医院耳鼻喉科诊断并治疗了5例累及颈部淋巴结的透明血管型卡斯特曼病。现介绍其中2例:一名24岁男性和一名13岁女性因无症状颈部肿块且生长缓慢而入院。辅助检查(放射学、颈部及腹部超声、CT扫描)证实了淋巴结病并排除了其他病变部位。鉴别诊断包括结核病、转移性淋巴结病、淋巴瘤、鳃裂囊肿等。
所有病例的首选治疗方法是通过颈部切开术进行手术切除,随后受累淋巴结出现血管增生和透明变性。术后复查未发现复发。
局限性透明血管型卡斯特曼病的预后优于多中心型,手术切除兼具诊断和治疗作用。