casteman病经cop方案化疗后好转1例报告并文献复习.docVIP

精品论文 参考文献 Casteman病经COP方案化疗后好转1例报告并文献复习 [摘 要]目的：认识Casteman病的临床特点、诊断、治疗及预 后情况。方法：报告1例Casteman病（浆细胞型）患者，结合复习有关文献，就Casteman病的临床表现、分型、治疗及预后进行讨论。结果：患者男性，34岁，双侧颈部、腋窝、纵膈、腹股沟及腹腔肿大淋巴结，取颈部淋巴结活检病理示血管滤泡性淋巴组织增生，浆细胞型。予COP方案化疗4周期，疗效CR。结论：Casteman病临床少见，极易误诊，确诊需进行病理和免疫组化检查。局灶型可手术切除，预后好；弥漫型可手术或COP方案化疗等年，预后不好，可发生恶变或死于感染。 [关键词]化疗 COP方案 淋巴结肿大 Casteman病 DOI:10.3760/cma.j.issn.0376-2491.2016.04.018 作者单位：252300，山东聊城市，阳谷县人民医院 A Report of the Improvement of One Casteman Disease Patient through COP Solution Yang Jinqi, Du Gengquan Abstract: Objective To explore the clinical characteristics of Casteman disease and its diagnosis, treatment and prognosis. Methods 1 patients with Casteman disease (plasma cell type) was studied based on reviewing literatures and the clinical manifestation, classification, treatment and prognosis of the Casteman disease patient were discussed. Results The patient is a male patients, 34 years old，with bilateral neck, armpits, mediastinum, groin and abdomen swollen lymph nodes. The neck lymph node biopsies showed vascular follicular lymphoid tissue hyperplasia, plasma cell type. According to the scheme of COP 4 chemotherapy cycles, the effect is CR. Conclusion: Casteman disease is rare in clinical, which could be easily misdiagnosed, and need a pathologic and immunohistochemical examination to diagnose. Focal type can be removed surgically, with good prognosis; diffuse type can take surgery or COP solutions such as chemotherapy, but the prognosis is not good, which means canceration or died of infection. \ Keywords: chemotherapy; COP solutions; swollen lymph nodes; Casteman disease 1 病例报告 患者，男，34岁，因双侧颈部肿块5年，腹胀2天于2007年3月13日收入院。患者于5年前无意中发现双侧颈部肿块，质韧，无疼痛及触痛，肿块可活动，无发热、盗汗，无咳嗽、咳痰。曾在多家医院就诊（具体诊治情况不详），治疗效果不佳，肿块逐渐增大，并出现腹胀、纳差。为求进一步治疗收入院。体检：双侧颈部、腋窝、腹股沟均可触及肿大淋巴结，大者约4㎝times;3㎝，质地韧，活动度差，无触痛。心肺检查无异常。腹部柔软，肝脾未触及，双下肢轻度水肿。辅助检查：血常规WBC10.7times;109/l、RBC4.55times;1012/l、HGB132g/l、PLT279times;109/l；尿常规 蛋白质2＋；LDH568u/ml；肝肾功能正常；心电图正常；胸腹部CT示纵膈、腹膜后多发肿大淋巴结，大