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Abstract：
BACKGROUND: Due to the lack of specificity symptoms and site of onset of castleman disease (CD), it is difficult to diagnose and poses unique challenges for both patients and clinicians, leading to confusion in diagnosis and delays in treatment. To enhance understanding, we present 3 cases of CD treated at our hospital, including a single-center, multicenter, and mixed-type CD.
METHODS: Case 1: A 53-year-old female patient was admitted with a chief complaint of \"abdominal pain and fever for 10 days.\" Marked enlargement of inguinal lymph nodes on both sides was observed. Case 2: A 58-year-old female patient was admitted with the main complaint of \"discovering a left lower abdominal mass during a routine checkup for the past 10 days.\" Upon deep palpation, a palpable mass of approximately 5.0 * 3.0 cm was identified in the left lower abdomen. Case 3: A 40-year-old male patient was admitted with the main complaint of \"progressive right upper abdominal and lumbar back pain for over 6 months.\" Computed tomography examination revealed multiple nodular soft tissue masses between the abdominal aorta and inferior vena cava, with the largest measuring 5.0 * 4.0 cm.
METHODS: Based on the immunohistochemical results, the diagnoses for the 3 patients are as follows: Case 1: Multicentric Castleman\'s Disease (Mixed Type). Case 2: Pelvic Retroperitoneal Castleman Disease (Hyaline Vascular Type). Case 3: Castleman Disease Multicentric Type.
METHODS: Case 1: cyclophosphamide 0.6-1 g + vincristine 2 mg + methylprednisolone 50 mg/5 days. Cyclophosphamide 1 g + prednisone 30-50 mg/5 days. This alternating chemotherapy cycle is repeated every 6 months. Case 2: Laparoscopic pelvic mass excision surgery. Case 3: Surgical excision of the mass.
RESULTS: Case 1: After a 43-month follow-up, the patient\'s general symptoms have improved compared to before, but regular chemotherapy is still necessary at present. Case 2: The patient did not take any medication postoperatively, and there has been no evidence of metastasis or recurrence during the 18-month follow-up. Case 3: The patient did not take any medication, and there has been no evidence of metastasis or recurrence during the 21-month follow-up.
UNASSIGNED: The lack of specific signs on imaging studies and nonspecific blood tests increases the difficulty of diagnosis. However, tissue biopsy remains a feasible option. Therefore, we recommend conducting thorough examinations for suspected CD patients to reduce misdiagnosis and determine the CD type for effective targeted treatment.
METHODS: Case 1: A 53-year-old female patient was admitted with a chief complaint of \"abdominal pain and fever for 10 days.\" Marked enlargement of inguinal lymph nodes on both sides was observed. Case 2: A 58-year-old female patient was admitted with the main complaint of \"discovering a left lower abdominal mass during a routine checkup for the past 10 days.\" Upon deep palpation, a palpable mass of approximately 5.0 * 3.0 cm was identified in the left lower abdomen. Case 3: A 40-year-old male patient was admitted with the main complaint of \"progressive right upper abdominal and lumbar back pain for over 6 months.\" Computed tomography examination revealed multiple nodular soft tissue masses between the abdominal aorta and inferior vena cava, with the largest measuring 5.0 * 4.0 cm.
METHODS: Based on the immunohistochemical results, the diagnoses for the 3 patients are as follows: Case 1: Multicentric Castleman\'s Disease (Mixed Type). Case 2: Pelvic Retroperitoneal Castleman Disease (Hyaline Vascular Type). Case 3: Castleman Disease Multicentric Type.
METHODS: Case 1: cyclophosphamide 0.6-1 g + vincristine 2 mg + methylprednisolone 50 mg/5 days. Cyclophosphamide 1 g + prednisone 30-50 mg/5 days. This alternating chemotherapy cycle is repeated every 6 months. Case 2: Laparoscopic pelvic mass excision surgery. Case 3: Surgical excision of the mass.
RESULTS: Case 1: After a 43-month follow-up, the patient\'s general symptoms have improved compared to before, but regular chemotherapy is still necessary at present. Case 2: The patient did not take any medication postoperatively, and there has been no evidence of metastasis or recurrence during the 18-month follow-up. Case 3: The patient did not take any medication, and there has been no evidence of metastasis or recurrence during the 21-month follow-up.
UNASSIGNED: The lack of specific signs on imaging studies and nonspecific blood tests increases the difficulty of diagnosis. However, tissue biopsy remains a feasible option. Therefore, we recommend conducting thorough examinations for suspected CD patients to reduce misdiagnosis and determine the CD type for effective targeted treatment.
摘要：
背景：由于缺乏特异性症状和castleman病（CD）的发作部位，很难诊断，对患者和临床医生都构成了独特的挑战，导致诊断混乱和治疗延误。为了增进了解，我们介绍了在我们医院治疗的3例CD，包括一个单一的中心，多中心，和混合型CD。
方法：案例1：一名53岁女性患者入院，主诉为“腹痛和发热”，持续10天。观察到两侧腹股沟淋巴结明显肿大。病例2：一名58岁女性患者入院，主诉为“在过去10天的常规检查中发现左下腹部肿块”。“在深触诊时，在左下腹部发现了约5.0*3.0cm的明显肿块.病例3：一名40岁男性患者入院，主诉为“进行性右上腹部和腰背部疼痛”，持续6个月以上。“计算机断层扫描检查显示腹主动脉和下腔静脉之间多发结节状软组织肿块，最大尺寸为5.0*4.0厘米。
方法：根据免疫组织化学结果，3例患者的诊断如下：病例1：多中心Castleman病（混合型）。病例2：骨盆腹膜后Castleman病（透明血管型）。案例3：Castleman病多中心型。
方法：病例1：环磷酰胺0.6-1g+长春新碱2mg+甲基强的松龙50mg/5天。环磷酰胺1克+泼尼松30-50毫克/5天。这种交替的化疗周期每6个月重复一次。病例2：腹腔镜盆腔肿块切除术。病例3：手术切除肿块。
结果：案例1：经过43个月的随访，患者的一般症状与以前相比有所改善，但是目前仍然需要定期化疗。病例2：患者术后未服用任何药物，在18个月的随访中，没有转移或复发的证据。案例3：患者没有服用任何药物，在21个月的随访中，没有转移或复发的证据。
■缺乏影像学检查和非特异性血液检查的特异性体征增加了诊断的难度。然而,组织活检仍然是一个可行的选择。因此,我们建议对疑似CD患者进行全面检查,以减少误诊,并确定CD类型,以便进行有效的针对性治疗.
方法：案例1：一名53岁女性患者入院，主诉为“腹痛和发热”，持续10天。观察到两侧腹股沟淋巴结明显肿大。病例2：一名58岁女性患者入院，主诉为“在过去10天的常规检查中发现左下腹部肿块”。“在深触诊时，在左下腹部发现了约5.0*3.0cm的明显肿块.病例3：一名40岁男性患者入院，主诉为“进行性右上腹部和腰背部疼痛”，持续6个月以上。“计算机断层扫描检查显示腹主动脉和下腔静脉之间多发结节状软组织肿块，最大尺寸为5.0*4.0厘米。
方法：根据免疫组织化学结果，3例患者的诊断如下：病例1：多中心Castleman病（混合型）。病例2：骨盆腹膜后Castleman病（透明血管型）。案例3：Castleman病多中心型。
方法：病例1：环磷酰胺0.6-1g+长春新碱2mg+甲基强的松龙50mg/5天。环磷酰胺1克+泼尼松30-50毫克/5天。这种交替的化疗周期每6个月重复一次。病例2：腹腔镜盆腔肿块切除术。病例3：手术切除肿块。
结果：案例1：经过43个月的随访，患者的一般症状与以前相比有所改善，但是目前仍然需要定期化疗。病例2：患者术后未服用任何药物，在18个月的随访中，没有转移或复发的证据。案例3：患者没有服用任何药物，在21个月的随访中，没有转移或复发的证据。
■缺乏影像学检查和非特异性血液检查的特异性体征增加了诊断的难度。然而,组织活检仍然是一个可行的选择。因此,我们建议对疑似CD患者进行全面检查,以减少误诊,并确定CD类型,以便进行有效的针对性治疗.
