U castleman trong trung thất sau - Tổng quan tài liệu và báo cáo ca bệnh

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Tác giả: Văn Công Cung

Ngôn ngữ: Vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam) 2022

Mô tả vật lý: 153-157

Bộ sưu tập: Metadata

ID: 392496

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Tóm tắt
Chủ đề

Bệnh Castleman (Castleman Disease - CD) là một rối loạn tăng sinh bạch huyết hiếm gặp, biểu hiện điển hình là sự tăng sinh của một hạch bạch huyết hoặc một vùng các hạch bạch huyết, thường xảy ra ở ngực. Bệnh nhân CD có thể không có triệu chứng hoặc biểu hiện các triệu chứng liên quan đến tác động của u đến các cấu trúc xung quanh. Rất khó để đạt được chẩn đoán xác định chỉ bằng hình ảnh. Chụp cắt lớp vi tính và/hoặc cộng hưởng từ đóng vai trò chủ đạo trong hỗ trợ chẩn đoán. Xét nghiệm mô học của tổn thương kết hợp nhuộm hoá mô miễn dịch (HMMD) là tiêu chuẩn vàng xác định bệnh. Cắt bỏ hoàn toàn bằng phẫu thuật là phương thức điều trị chính tốt nhất cho CD, mang lại khả năng sống sót lâu dài và tỷ lệ tái phát thấp. Một số ít có thể phối hợp điều trị bằng kháng thể đơn dòng cho thấy có hiệu quả. Tại ngực u Castleman thường phát hiện ở trung thất trước và rất hiếm gặp ở trung thất sau. Chúng tôi báo cáo 1 trường hợp CD gặp ở trung thất sau, sinh thiết xuyên thành ngực 2 lần đều cho kết quả không đúng. Bệnh nhân được phẫu thuật, kết quả giải phẫu bệnh (GPB) và HMMD chứng minh u CD. Phần bàn luận theo các tài liệu tổng quan sẽ giúp cho các độc giả có thể hiểu sâu hơn về căn bệnh này., Tóm tắt tiếng anh, Castleman Disease (CD) is a rare lymphoproliferative disorder typically characterized by the proliferation of a single or regional lymph node, usually occurring in the chest. Patients with CD may be asymptomatic or present with symptoms related to tumor impact on surrounding structures. It is difficult to reach a definitive diagnosis by imaging alone. Computed tomography and/or magnetic resonance imaging play a dominant role in supporting the diagnosis. Histological examination of lesions combined with immunohistochemical staining is the gold standard for disease identification. Complete surgical resection is the best primary treatment modality for CD, offering long-term survival and low recurrence rates. A few can be combined with monoclonal antibody therapy to be effective. In the chest, Castleman tumors are usually found in theanterior mediastinum and very rarely in the posterior mediastinum. We report one case of CD found in the posterior mediastinum, twice transthoracic biopsies gave incorrect results. The patient underwent surgery, histopathological results and immunohistochemical staining confirmed a CD tumor. The discussion of the literature review will help readers gain a deeper understanding of this disease.

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