Endobronchial Ultrasound Imaging of Castleman's Disease: Two Case Reports

Castleman氏病的支氣管內視鏡超音波－案例報告

陳永瑄(Yung-Hsuan Chen) ； 何肇基(Chao-Chi Ho)

《胸腔醫學》 32卷6期 (2017/12) Pp. 279-285

摘要

Castleman’s disease (CD) is a rare lymphoproliferative disorder that usually involves the mediastinum. The diagnosis of CD is usually established by excisional lymph node biopsy. Based on the histological features, the disease can be classified into 3 types: hyalinevascular, plasma cell type, and mixed type. We report the cases of 2 patients with CD, both of whom underwent endobronchial ultrasound (EBUS) and surgical biopsy. In the first case, EBUS showed a hilar mass with hypervascularity, and the final diagnosis was hyalinevascular- type CD. In the second case, EBUS showed lymphadenopathy at group 11R with hypovascularity, and the final diagnosis was plasma cell-type CD. For those CD patients with an initial presentation of mediastinal lymphadenopathy, pre-operative EBUS imaging might provide more information on the lesion. Moreover, EBUS-guided transbronchial needle aspiration could even enable sampling of tissue cores for histological diagnosis.

關鍵字

Castleman's disease ； endobronchial ultrasound ； hilar mass ； mediastinal lymphadenopathy

並列摘要

Castleman氏病是一種罕見且經常侵犯縱膈腔的淋巴增生性疾病，其診斷常藉由手術來執行淋巴結切片。此病可依據組織學特色分成以下三種類型：透明血管型、漿細胞型、及混和型。我們提出討論的兩位Castleman氏病個案皆有接受支氣管內視鏡超音波檢查及淋巴結切片手術。第一位個案的支氣管內視鏡超音波檢查發現有一富血管性之肺門腫塊，其最後診斷為透明血管型Castlman氏病；第二位則是經支氣管內視鏡超音波檢查發現有11R的淋巴結腫大且較不具有血管分布，其最後診斷為漿細胞型Castlman氏病。術前支氣管內視鏡超音波檢查的影像或許可提供給臨床人員更多關於病灶的資訊。當病灶可執行經支氣管內視鏡超音波指引細針抽吸時，有機會取得足夠的檢體以得到組織學診斷。

並列關鍵字

Castleman氏病 ； 氣管內視鏡超音波 ； 肺門腫塊 ； 縱膈腔淋巴結腫大