Gunluoglu Gulsah, Olcmen Aysun, Sokucu Sinem Nedime, Akin Hasan, Dincer Ibrahim
Department of Chest Diseases, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey.
Ann Thorac Cardiovasc Surg. 2011;17(6):580-3. doi: 10.5761/atcs.cr.10.01644. Epub 2011 Jul 27.
Castleman's disease (CD) is a rare disease with unknown aetiology. It is characterised by benign lymph node hyperplasia that may involve all lymph nodes. The most common locations are the mediastinum and abdomen. CD arising from intrapulmonary lymph nodes has been reported in five cases, in the English language literature to date. Tumours in these patients are usually resected during lung surgery. An asymptomatic 29-year-old male patient was evaluated due to a mass lesion with a diameter of 55 mm located in the infrahilar region of the right lung with a high degree of contrast enhancement on thoracic computed tomography (CT). Vascularity of this central lesion was excluded by pulmonary angiography. Thoracotomy was performed due to the inability to obtain a diagnosis with percutaneous fine needle aspiration biopsies. A frozen section examination of the mass revealed a benign lesion, arising from the intrapulmonary lymph nodes and protruding to the lower-lobe parenchyma. The mass was then extracted from the parenchyma. After histopathological evaluation of the mass, CD involving the lymph nodes was diagnosed. CD rarely involves the intrapulmonary lymph nodes. Diagnosis is difficult in these patients, and thoracotomy may be required. After obtaining benign results by mass sampling, limited resection of these masses, while sparing the lung parenchyma, may be possible.
卡斯特曼病(Castleman病,CD)是一种病因不明的罕见疾病。其特征为良性淋巴结增生,可累及所有淋巴结。最常见的部位是纵隔和腹部。迄今为止,英文文献中报道了5例起源于肺内淋巴结的CD。这些患者的肿瘤通常在肺部手术期间切除。一名29岁无症状男性患者因右肺肺门以下区域出现直径55 mm的肿块病变接受评估,胸部计算机断层扫描(CT)显示该病变有高度强化。通过肺血管造影排除了该中心病变的血管性。由于经皮细针穿刺活检无法确诊,故进行了开胸手术。对肿块进行冰冻切片检查发现是一个良性病变,起源于肺内淋巴结并突入下叶实质。然后从实质中取出肿块。对肿块进行组织病理学评估后,诊断为累及淋巴结的CD。CD很少累及肺内淋巴结。这些患者诊断困难,可能需要开胸手术。在通过肿块取样获得良性结果后,在保留肺实质的同时,对这些肿块进行有限切除可能是可行的。