Castleman病临床特征分析OA

Objective To investigate the clinical manifestations,treatment,and prognosis of Castleman disease(CD),thereby improving the understanding and diagnosis of the disease.Methods A retrospective analysis was conducted on the clinical data of 87 patients with CD admitted between June 2015 and June 2025.Results Among the 87 patients,39 were males and 48 were females,aged 39.5±18.4 years;hyaline-vascular type(HV type)accounted for 52.9％,plasma cell type(PC type)accounted for 33.3％,and the mixed type was 13.8％.There were 42 cases of unicentric CD(UCD)and 45 cases of idiopathic multicentric CD(iMCD).The most common sites of involvement in iMCD patients were head and neck lymph nodes(55.6％),followed by axillary lymph nodes(46.7％),and abdominal lymph nodes(37.8％).The rate of complaints in UCD patients was 52.3％.iMCD patients were accompanied by systemic symptoms,abnormal laboratory test results,splenomegaly,pleural effusion and/or ascites.Compared with UCD patients,iMCD patients had lower hemoglobin,albumin,and platelets,but higher serum creatinine and C-reactive protein,erythrocyte sedimentation rate levels than UCD patients(P＜0.05).Accordingly,95.2％of UCD patients were treated with surgical removal of lymph nodes,and the postoperative recurrence rate was 2.4％.iMCD patients received targeted therapy,Glucocorticoids,and combination chemotherapy regimens with an objective response rate of 71.1％.Conclusion CD is relatively rare in clinical practice and difficult to differentiate and diagnose.Patients with UCD have a good prognosis after surgery,while patients with iMCD develop different degrees of inflammatory responses involving multiple systems and require comprehensive treatment with targeted therapies,chemotherapy,and symptomatic supportive therapy.