• 四川大學(xué)華西醫(yī)院（成都，610041）1泌尿外科，2病理科;

目的 　觀察腹膜后巨淋巴結(jié)增殖癥的治療效果，探討其臨床表現(xiàn)、影像學(xué)特點(diǎn)、診斷、病理及治療方法。 方法 　30歲女性患者1例，因反復(fù)腹瀉、右上腹脹2個(gè)月余，發(fā)現(xiàn)右側(cè)腹膜后腫物20 d，于2011年8月22日入院。患者在全麻下行腹膜后腫物切除術(shù)。手術(shù)3個(gè)月后，復(fù)查腹部CT、血常規(guī)、生化等檢查。并結(jié)合文獻(xiàn)進(jìn)行綜述。 結(jié)果　 手術(shù)過(guò)程順利，完整切除腫物，術(shù)后病理檢查示病變?yōu)榫蘖馨徒Y(jié)增殖癥，透明血管型。術(shù)后3個(gè)月患者門(mén)診隨訪，恢復(fù)良好，復(fù)查腹部CT未見(jiàn)腫物復(fù)發(fā)，血常規(guī)、生化等檢查均無(wú)異常。 結(jié)論 　該病較為少見(jiàn)，病因尚不明確，確診需依賴病理組織學(xué)活檢，手術(shù)切除為首選治療，且預(yù)后好。

引用本文： 黃中力,張朋,魏武然,龔靜,石明. 腹膜后巨淋巴結(jié)增殖癥一例. 華西醫(yī)學(xué), 2012, 27(6): 895-898. doi: 復(fù)制

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1. 　Castleman B, Iverson L, Menendez VP. Localized mediastinal lymphnode hyperplasia resembling thymoma[J]. Cancer, 1956, 9(4): 822-830.
2. 　Yeh CM, Chou CM, Wong LC. Castleman’s disease mimicking intrapulmonary malignancy[J]. Ann Thorac Surg, 2007, 84(2): 6-7.
3. 　Krawczun GA, Garcia Cde M, Ito K, et al. Castleman’s disease or angiofollicular hyperplasia as a solitary pulmonary nodule: case report[J]. J Bras Pneumol, 2007, 33(2): 226-228.
4. 　Barrie JR, English JC, Muller N. Castleman’s disease of the lung: radiographic, high-resolution CT, and pathologic findings[J]. Am J Roentgenol, 1996, 166(5): 1055-1056.
5. 　Awotedu AA, Otulana BA, Ukoli CO. Giant lymph node hyperplasia of the lung Castleman’s disease associated with recurrent pleural effusion[J]. Thorax, 1990, 45(10): 775-776.
6. 　Rena O, Casadio C, Maggi G. Castleman’s disease:unusual intrathoracic Localization[J]. Eur J Cardiothorac Surg, 2001, 19(4)：519-521.
7. 　Mcadams HP, Fishback NF, Templeton PA. Castleman disease of the thorax: radiologic features with clinical and histopathologic correlation [J]. Radiology, 1998, 209(1): 221-228.
8. 　Newsomi-Davis T, Bower M, Wildfire A, et al. Resolution of AIDS-related Castlemans’disease with anti-CD20 monoclonal antibodies is associated with declining IL-6 and TNF-alpha levels[J]. Leuk Lymphoma, 2004, 45(9): 1939-1941.
9. 　Pauwels P, Dalcin P, Vlasveld LT, et al. A chromosomal abnormality in hyalin vascular Castleman’s disease：evidence for clonal proliferation of dysplastic stromal cells[J]. Am J Surg Pathol, 2000, 24(6): 882-888.
10. 　Nguyen DT, Diamond LW,et al. Castleman’s disease.Differences in Follicular dendritic network in the hyaline vascular and plasma cell variants[J]. Histopathology, 1994, 24(5): 437-443.
11. 　Soulier J, Grollet L, Oksenhendler E, et al. Kaposi`s sarcoma-associated herpes virus-like DNA sequences in multicentric Castleman’s disease[J]. Blood, 1995, 86(4): 1276 -1280.
12. 　Parravinci C, Corbellino M, Paulli M, et al. Expression of a virus-derived cytokine, KSHV vIL-6, in HIV-seronegative Castleman’s disease[J]. Am J Pathol, 1997, 151(6): 1517 -1522 .
13. 　Lallemand F, Desire N, Rozenbaum W, et al. Quantitative analysis of human herpesvirus 8 viral load using a real-time PCR assay[J]. J C lin Microbiol, 2000, 38(4): 1404-1408.
14. 　Jongsma TE, Verburg RJ, Geelhoed-Dui-Jvestijn PH. Castleman’s disease: a rare lymphoproliferative disorder[J]. Eur J Intern Med, 2007, 18(8): 87-89.
15. 　Hatano K, Fujita S,Tsujimoto Y, et al. Rare case of the hyaline vascular Type of Castleman’s disease of the kidney[J]. Int J Urol, 2007, 14(12): 1098-1100.
16. 　張暉, 俞清, 杜紅, 等.Castleman病的影像學(xué)診斷[J]. 中華超聲影像學(xué)雜志, 2005, 14(6): 441-444.
17. 　周嘉慧, 曾蒙蘇, 張雪梅. CT巨大淋巴結(jié)增生癥的表現(xiàn)與分析[J].醫(yī)學(xué)影像學(xué)雜志, 2006, 16(12): 1260-1262.
18. 　游興攀, 官彬, 唐勇, 等.巨淋巴結(jié)增生的CT、MRI表現(xiàn)[J].重慶醫(yī)學(xué), 2010, 39(7): 834-835, 838.
19. 　時(shí)克偉, 王林省, 宋光義.巨淋巴結(jié)增生癥的CT表現(xiàn)特征[J].濟(jì)寧醫(yī)學(xué)院學(xué)報(bào), 2009, 32(3): 187-188.
20. 　Herrada J, Cabanillas F, Rice L, et al. The clinical behavior of localized and multicentric Castleman disease[J]. Ann Intern Med, 1998, 128(8): 657-662.
21. 　Zhu YC, Huang Y, Yao J, et al. A rare case of Castleman’s disease of plasma cell type within kidney[J]. Chin Med J, 2009, 122(19): 2396-2398.
22. 　Okada S, Maeta H, Maeba T, et al. Castleman disease of the pararenal retroperitoneum: report of a case[J]. Surg Today, 1999, 29(2): 178-181.
23. 　Chronowski GM, Ha CS, Wilder RB, et al.Treatment of unicentric and multicentric Castleman disease and the role of radiotherapy[J].Cancer, 2001, 92(3): 670-676.
24. 　Cadeddu MO, Mammazza J, Schlachta CM, et al. Laparoscopic excision of retroperitoneal tumors: technique and review of the laparoscopic experience[J]. Surg Laparosc Endosc Percutan Tech, 2001, 11(2): 144-147.
25. 　Dalpiaz O, Gidaro S, Lipsky K, et al. Case report: laparoscopic removal of 10-cm retroperitoneal liposarcoma[J]. J Endourol, 2007, 21(1): 83-84.
26. 　Xia D, Wang S, Li QM, et al. Laparoscopic approach of Castleman’s disease in the pararenal retroperitoneum: report of two cases[J]. Chin Med J, 2010, 123(13): 1809-1811.
27. 　王琳, 秦平, 侯明. 多中心性Castleman病3例[J]. 臨床血液學(xué)雜志, 2004, 17(5): 307-308.
  1. 1. 　Castleman B, Iverson L, Menendez VP. Localized mediastinal lymphnode hyperplasia resembling thymoma[J]. Cancer, 1956, 9(4): 822-830.
  2. 2. 　Yeh CM, Chou CM, Wong LC. Castleman’s disease mimicking intrapulmonary malignancy[J]. Ann Thorac Surg, 2007, 84(2): 6-7.
  3. 3. 　Krawczun GA, Garcia Cde M, Ito K, et al. Castleman’s disease or angiofollicular hyperplasia as a solitary pulmonary nodule: case report[J]. J Bras Pneumol, 2007, 33(2): 226-228.
  4. 4. 　Barrie JR, English JC, Muller N. Castleman’s disease of the lung: radiographic, high-resolution CT, and pathologic findings[J]. Am J Roentgenol, 1996, 166(5): 1055-1056.
  5. 5. 　Awotedu AA, Otulana BA, Ukoli CO. Giant lymph node hyperplasia of the lung Castleman’s disease associated with recurrent pleural effusion[J]. Thorax, 1990, 45(10): 775-776.
  6. 6. 　Rena O, Casadio C, Maggi G. Castleman’s disease:unusual intrathoracic Localization[J]. Eur J Cardiothorac Surg, 2001, 19(4)：519-521.
  7. 7. 　Mcadams HP, Fishback NF, Templeton PA. Castleman disease of the thorax: radiologic features with clinical and histopathologic correlation [J]. Radiology, 1998, 209(1): 221-228.
  8. 8. 　Newsomi-Davis T, Bower M, Wildfire A, et al. Resolution of AIDS-related Castlemans’disease with anti-CD20 monoclonal antibodies is associated with declining IL-6 and TNF-alpha levels[J]. Leuk Lymphoma, 2004, 45(9): 1939-1941.
  9. 9. 　Pauwels P, Dalcin P, Vlasveld LT, et al. A chromosomal abnormality in hyalin vascular Castleman’s disease：evidence for clonal proliferation of dysplastic stromal cells[J]. Am J Surg Pathol, 2000, 24(6): 882-888.
  10. 10. 　Nguyen DT, Diamond LW,et al. Castleman’s disease.Differences in Follicular dendritic network in the hyaline vascular and plasma cell variants[J]. Histopathology, 1994, 24(5): 437-443.
  11. 11. 　Soulier J, Grollet L, Oksenhendler E, et al. Kaposi`s sarcoma-associated herpes virus-like DNA sequences in multicentric Castleman’s disease[J]. Blood, 1995, 86(4): 1276 -1280.
  12. 12. 　Parravinci C, Corbellino M, Paulli M, et al. Expression of a virus-derived cytokine, KSHV vIL-6, in HIV-seronegative Castleman’s disease[J]. Am J Pathol, 1997, 151(6): 1517 -1522 .
  13. 13. 　Lallemand F, Desire N, Rozenbaum W, et al. Quantitative analysis of human herpesvirus 8 viral load using a real-time PCR assay[J]. J C lin Microbiol, 2000, 38(4): 1404-1408.
  14. 14. 　Jongsma TE, Verburg RJ, Geelhoed-Dui-Jvestijn PH. Castleman’s disease: a rare lymphoproliferative disorder[J]. Eur J Intern Med, 2007, 18(8): 87-89.
  15. 15. 　Hatano K, Fujita S,Tsujimoto Y, et al. Rare case of the hyaline vascular Type of Castleman’s disease of the kidney[J]. Int J Urol, 2007, 14(12): 1098-1100.
  16. 16. 　張暉, 俞清, 杜紅, 等.Castleman病的影像學(xué)診斷[J]. 中華超聲影像學(xué)雜志, 2005, 14(6): 441-444.
  17. 17. 　周嘉慧, 曾蒙蘇, 張雪梅. CT巨大淋巴結(jié)增生癥的表現(xiàn)與分析[J].醫(yī)學(xué)影像學(xué)雜志, 2006, 16(12): 1260-1262.
  18. 18. 　游興攀, 官彬, 唐勇, 等.巨淋巴結(jié)增生的CT、MRI表現(xiàn)[J].重慶醫(yī)學(xué), 2010, 39(7): 834-835, 838.
  19. 19. 　時(shí)克偉, 王林省, 宋光義.巨淋巴結(jié)增生癥的CT表現(xiàn)特征[J].濟(jì)寧醫(yī)學(xué)院學(xué)報(bào), 2009, 32(3): 187-188.
  20. 20. 　Herrada J, Cabanillas F, Rice L, et al. The clinical behavior of localized and multicentric Castleman disease[J]. Ann Intern Med, 1998, 128(8): 657-662.
  21. 21. 　Zhu YC, Huang Y, Yao J, et al. A rare case of Castleman’s disease of plasma cell type within kidney[J]. Chin Med J, 2009, 122(19): 2396-2398.
  22. 22. 　Okada S, Maeta H, Maeba T, et al. Castleman disease of the pararenal retroperitoneum: report of a case[J]. Surg Today, 1999, 29(2): 178-181.
  23. 23. 　Chronowski GM, Ha CS, Wilder RB, et al.Treatment of unicentric and multicentric Castleman disease and the role of radiotherapy[J].Cancer, 2001, 92(3): 670-676.
  24. 24. 　Cadeddu MO, Mammazza J, Schlachta CM, et al. Laparoscopic excision of retroperitoneal tumors: technique and review of the laparoscopic experience[J]. Surg Laparosc Endosc Percutan Tech, 2001, 11(2): 144-147.
  25. 25. 　Dalpiaz O, Gidaro S, Lipsky K, et al. Case report: laparoscopic removal of 10-cm retroperitoneal liposarcoma[J]. J Endourol, 2007, 21(1): 83-84.
  26. 26. 　Xia D, Wang S, Li QM, et al. Laparoscopic approach of Castleman’s disease in the pararenal retroperitoneum: report of two cases[J]. Chin Med J, 2010, 123(13): 1809-1811.
  27. 27. 　王琳, 秦平, 侯明. 多中心性Castleman病3例[J]. 臨床血液學(xué)雜志, 2004, 17(5): 307-308.