Liu Dingding, Sun Feihu, Wei Hao, Wang Junguo, Qian Xiaoyun
Department of Otolaryngology Head and Neck Surgery，Affiliated Drum Tower Hospital of Nanjing University Medical School，Jiangsu Provincial Key Medical Discipline，Research Institute of Otolaryngology，Nanjing，210008，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jul;36(7):545-548. doi: 10.13201/j.issn.2096-7993.2022.07.013.
To investigate the clinicopathological features, treatment and prognosis of Castleman disease in the head and neck. The clinical and pathological data of 18 patients with Castleman disease of the head and neck in Nanjing Drum Tower Hospital from 2007 to 2021 were retrospectively analyzed. There were 14 cases of unicentric type and 4 cases of multicentric type. The clinical characteristics, treatment and prognosis were analyzed. Among the 18 cases of Castleman disease in the head and neck, 1 case was located in the parotid gland, 1 case was behind the ear, 1 case was in the parapharyngeal space, 3 cases were in the neck region Ⅰ, 2 cases were supraclavicular, 2 cases were in the neck region Ⅲ, the rest were located in more than two subregions of the neck. In patients with unicentric type, no tumor recurrence and progression were found in the postoperative re-examination with neck Doppler ultrasound and CT; in the multicentric type, multiple organ dysfunction, such as edema of both lower extremities, hepatosplenomegaly, and cough, were found. Of the 4 patients with multicentric type, only 1 patient received chemotherapy, and the remaining 3 patients refused chemotherapy and only received symptomatic treatment. All patients survived during follow-up, but the disease of multicentric patients progressed significantly, and the number of involved lymph nodes increased, and hepatosplenomegaly were found in some patients. Castleman disease of the head and neck is mostly unicentric type, which is manifested as multiple asymptomatic enlarged lymph nodes in the neck. The surgical resection is effective and the prognosis is good. Multicentric Castleman disease of the head and neck has complex clinical symptoms and involves multiple organs over time, requiring follow-up treatment.
探讨头颈部Castleman病的临床病理特征、治疗方法及预后。回顾性分析2007年至2021年南京鼓楼医院收治的18例头颈部Castleman病患者的临床及病理资料。其中单中心型14例，多中心型4例。对其临床特征、治疗方法及预后进行分析。18例头颈部Castleman病患者中，1例位于腮腺，1例位于耳后，1例位于咽旁间隙，3例位于Ⅰ区颈部，2例位于锁骨上，2例位于Ⅲ区颈部，其余位于颈部两个以上亚区。单中心型患者术后经颈部多普勒超声及CT复查未见肿瘤复发及进展；多中心型患者出现双下肢水肿、肝脾肿大、咳嗽等多器官功能障碍。4例多中心型患者中，仅1例接受化疗，其余3例拒绝化疗，仅接受对症治疗。所有患者随访期间均存活，但多中心型患者病情进展明显，受累淋巴结数目增多，部分患者出现肝脾肿大。头颈部Castleman病多为单中心型，表现为颈部多发无症状肿大淋巴结。手术切除有效，预后良好。头颈部多中心型Castleman病临床症状复杂，随时间推移累及多个器官，需随访治疗。
