Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
Radiat Oncol. 2010 Feb 2;5:7. doi: 10.1186/1748-717X-5-7.
Castleman disease (CD) is a rare benign disorder characterised by hyperplasia of lymphoid tissue that may develop at a single site or throughout the body. The etiology of this disorder is unclear, although the histopathological presentation can be differentiated into a hyaline vascular variant, a plasma cell variant and a mixed variant. Clinically, it has been recorded that 3 manifestations of CD are characterized: a localized unicentric type, a generalized multicentric type and a mixed form. Surgery remains the main treatment for resectable unicentric CD, since removal of the large node is possible without further complications. No consensus has been reached concerning the most adequate treatment for irresectable unicentric CD.
Case report of a 67 year old woman.
This report, describes the case of a 67-year-old woman with unicentric Castleman disease located in the right lower abdomen. The patient had symptoms of fatigue, dyspnoea and pain in the right lower abdomen. Computed tomography (CT)- examination revealed a tumour, which had grown to form a close relationship with the common iliac vessels and the sacral bone. A Laparotomy procedure revealed that the tumour was an irresectable mass. Neo-adjuvant radiotherapy (40 Gy) was administered in order to downsize the tumour. Six weeks later a new CT-scan revealed a major reduction of the tumour, which enabled a successful radical resection of the tumour to be performed. Histopathological analysis of the tumour showed the hyaline vascular type of CD.
Neo-adjuvant radiotherapy should be considered in case of an irresectable unicentric CD.
卡斯特曼病（CD）是一种罕见的良性疾病，其特征为淋巴组织增生，可单发或全身发病。该病病因尚不清楚，但组织病理学表现可分为透明血管型、浆细胞型和混合型。临床上，CD 有 3 种表现形式：局限性单中心型、全身性多中心型和混合性。对于可切除的单中心 CD，手术仍然是主要治疗方法，因为可以在不引起进一步并发症的情况下切除大的淋巴结。对于不可切除的单中心 CD，尚无最佳治疗方法的共识。
报告 1 例 67 岁女性患者。
本报告描述了 1 例 67 岁女性患者的单中心 CD 病例，位于右下腹部。患者有疲劳、呼吸困难和右下腹痛的症状。计算机断层扫描（CT）检查显示肿瘤与髂总血管和骶骨紧密相连。剖腹探查显示肿瘤不可切除。给予新辅助放疗（40Gy）以缩小肿瘤。6 周后，新的 CT 扫描显示肿瘤明显缩小，使肿瘤能够成功进行根治性切除。肿瘤的组织病理学分析显示为透明血管型 CD。
对于不可切除的单中心 CD，应考虑新辅助放疗。
