摘要
目的探讨肾上腺Castleman病的临床特点及诊治方法。方法分析首都医科大学附属北京安贞医院泌尿外科2019年1月收治的1例肾上腺Castleman病患者的临床资料并结合文献复习讨论。结果患者女,29岁,因"发现右肾上腺肿物1周"就诊,腹部超声示右肾上腺区域5.0 cm×4.0 cm低回声不均质占位,边界清晰。CT扫描示右肾上腺区4.2 cm×3.8 cm软组织肿块,平扫CT值43 HU,注射造影剂后不均匀强化。术前诊断为右肾上腺肿瘤,不除外嗜铬细胞瘤。采用腹腔镜下右肾上腺切除术,术中见肿块累及右肾上腺中下部,向下压迫右肾动静脉,周边血供较丰富,并与周围脂肪组织致密粘连。切下标本可见肿物大小4.5 cm×4.0 cm×1.5 cm。术后病理诊断:右肾上腺单中心型Castleman病,透明血管型。术后恢复良好,随访6个月未见肿瘤复发。结论肾上腺Castleman病临床上罕见。CT平扫及增强有助于诊断,但确诊需要病理结果。单中心型Castleman病手术切除疗效好。
Objective To investigate the clinical characteristics,diagnosis and treatment of adrenal Castleman’s disease.Methods One case of adrenal Castleman’s disease were analyzed with literature review.Results A 29-year-old female patient with Castleman’s disease of right adrenal gland admitted in Beijing Anzhen Hospital,Capital Medical University was treated.Abdominal ultrasound showed that the right adrenal area was5.0 cm×4.0 cm low echo and heterogeneous,with clear boundary.CT scan showed a soft tissue mass of4.2 cm×3.8 cm in the right adrenal area,with a plain CT value of 43 HU;there was uneven enhancement after injection of contrast medium.The right adrenal tumor was diagnosed preoperatively.Laparoscopic right adrenalectomy was used.The mass involved the middle and lower part of the right adrenal gland.The right renal artery and vein were affected.The peripheral blood supply was tightly connected with the surrounding adipose tissue.The size of the tumor was 4.5 cm×4.0 cm×1.5 cm.Postoperative pathological diagnosis was right adrenal monocentric Castleman disease and hyaline vascular type.The postoperative recovery was good and no recurrence was found after 6-month follow-up.Conclusions Adrenal Castleman’s disease is clinically rare.CT scan is helpful for diagnosis but the diagnosis still depends on pathology.Surgical resection is effective in treating unicentric Castleman’s disease.
作者
林云华
王俊生
王永兴
罗勇
姜永光
Lin Yunhua;Wang Junsheng;Wang Yongxing;Luo Yong;Jiang Yongguang(Department of Urology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)
出处
《中国医药》
2020年第8期1305-1308,共4页
China Medicine
基金
北京市自然科学基金(7172068)。
