侵犯肾静脉的Castleman病误诊临床分析
Clinical Analysis of Misdiagnosis of Castleman's Disease with Renal Vein In-vasion
王永顺 1刘乃青2
作者信息
- 1. 261053 山东潍坊,山东第二医科大学临床医学院;276400 山东临沂,临沂市中心医院普外科
- 2. 276400 山东临沂,临沂市中心医院普外科
- 折叠
摘要
目的 探讨Castleman病(CD)的临床特点及鉴别诊断要点,以减少误诊误治.方法 回顾性分析2023年收治的1 例CD的临床资料,并复习相关文献.结果 1 例女性因发现腹腔占位10 余天入院.入院完善相关检查,肿瘤标志物等未见异常.全腹部强化CT检查考虑畸胎瘤可能性大,腹膜后多发增大淋巴结.经多学科专家会诊后,行腹膜后病灶切除术、部分肾静脉切除术、肾静脉-下腔静脉自体大隐静脉搭桥术治疗,术后病理示CD,治愈出院.结论 部分CD患者无明显临床表现,易误诊.临床鉴别CD与其他腹腔肿瘤时,应行多学科会诊并重视病理及免疫组织化学结果,仔细询问病史及查体,认真鉴别诊断,以减少或避免误诊误治.
Abstract
Objective To explore the clinical features of Castleman's disease(CD)and the key points of differential diagnosis,in order to reduce the misdiagnosis and mistreatment.Methods The clinical data of 1 patient with CD treated in 2023 were retrospectively analyzed,and the relevant literature was reviewed.Results One female was admitted to hospital due to abdominal space occupying for more than 10 d.After admission,the relevant examinations were performed,and no ab-normalities were found in tumor markers.Enhanced CT examination of the whole abdomen suggested the possibility of teratoma and multiple enlarged retroperitoneal lymph nodes.After multidisciplinary expert consultation,retroperitoneal foci resection,partial renal venectomy,renal vena-inferior vena cava autologous great saphenous vein bypass surgery were performed.The postoperative pathology showed CD,and the patient was cured and discharged.Conclusion Several patients with CD have no obvious clinical manifestations and are more likely to experience misdiagnosis.In clinical differentiation of CD and other ab-dominal tumors,multidisciplinary consultation should be carried out,attention should be paid to pathological and immunohis-tochemical results,and careful medical history and physical examination,and careful differential diagnosis are needed to re-duce or avoid misdiagnosis and mistreatment.
关键词
Castleman病/误诊/畸胎瘤/多学科联合/部分肾静脉切除术/肾静脉-下腔静脉自体大隐静脉搭桥术/病理检查/诊断,鉴别Key words
Castleman's disease/Misdiagnosis/Teratoma/Multidisciplinary collaboration/Partial nephrectomy/Re-nal vene-inferior vena cava autogenous great saphenous vein bypass surgery/Pathological examination/Diagnosis,differential引用本文复制引用
基金项目
山东第二医科大学附属医院科技发展重点项目资助(2023FYZ017)
出版年
2024
国家科技期刊平台
NSTL
万方数据