Bi Xianyun, Huang Rui, Ming Cheng, Lou Fan, Xie Yucheng, Yang Heng, Ma Jing
Department of Otolaryngology Head and Neck Surgery,Kunming Children's Hospital,Kunming,650228,China.
Department of Pathology,Kunming Children's Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Aug;38(8):732-736. doi: 10.13201/j.issn.2096-7993.2024.08.011.
To investigate the clinical features, imaging findings, pathological phenotype, treatment and prognosis of unicentric Castleman disease in the children's neck, in order to improve the understanding of CD among Otolaryngology Head and Neck Surgery. Retrospective cross-sectional, observational study was undertaken in Kunming Children's Hospital, from the archival data between January July 2015 and June 2020. Only 6 cases of CD were identified after studying the histomorphological characteristics and neck mass diagnosed. The imaging and pathological features were summarized and the pathogenesis was discussed. Among the 6 cases of Castleman disease, five were male and one was female. Histopathology: Five cases were hyaline vascular subtype, one was mixed type. The uniform clinicopathologic features seen in all hyaline vascular subtype of CD included atrophic germinal centre with lymphocyte depletion, concentric rings of small lymphocytes, increased vascularity and predominance of high endothelial vessels in interfollicular region. Twinning, in which two or more germinal centers are combined and surrounded by lymphocytes in the mantle zone was observed in two cases with lollipop pattern at the same time. All the cases underwent complete surgical resection, the median follow-up time was 48 months(26, 84), both of them had good prognosis. Most cases of unicentric type CD in children are diagnosed late, which is clinical showed by painless lymphadenopathy. The most common pathological type is hyaline vascular. The overall prognosis of surgical treatment was good.
探讨儿童颈部单中心Castleman病的临床特征、影像学表现、病理表型、治疗及预后,以提高耳鼻咽喉头颈外科对Castleman病的认识。对昆明市儿童医院2015年1月至2020年6月期间的存档数据进行回顾性横断面观察研究。在研究组织形态学特征和诊断的颈部肿块后,仅发现6例Castleman病。总结了影像学和病理特征并讨论了发病机制。6例Castleman病中,男性5例,女性1例。组织病理学:5例为透明血管型,1例为混合型。所有透明血管型Castleman病均可见的一致临床病理特征包括生发中心萎缩伴淋巴细胞减少、小淋巴细胞同心环、血管增多以及滤泡间区高内皮血管占优势。在2例同时出现棒棒糖样模式的病例中观察到孪生现象,即两个或更多生发中心合并并被套区淋巴细胞包围。所有病例均接受了完整的手术切除,中位随访时间为48个月(26, 84),两者预后均良好。儿童单中心型Castleman病大多诊断较晚,临床表现为无痛性淋巴结肿大。最常见的病理类型是透明血管型。手术治疗总体预后良好。