叶敬霆+李文辉+曹乾乾

    [摘要] 血管滤泡性淋巴结增生症，又称Castleman's Disease(CD)、巨淋巴结增生症，是一种罕见的原因不明的慢性淋巴组织增生性疾病，主要以慢性渐进性淋巴结肿大为特征。该病误诊率较高，确诊有赖于病理检查。本例为1例46岁男性患者，因体检发现后纵膈占位1年入院，初诊为“后纵隔肿瘤；畸胎瘤？”，拟行胸腔镜辅助下纵隔肿瘤切除术，术中切除困难，出血量多，中转开胸后成功切除肿块。术后病理提示血管滤泡性淋巴结增生症，透明血管型，随访10个月未见复发证据。该病例手术效果虽满意，但如术前即可明确诊断并了解肿瘤特性，可减少术中对患者造成的损害，遂复习相关文献并进行分析、总结。

    [关键词] 血管滤泡性淋巴结增生症；巨淋巴结增生症；后纵隔肿瘤；免疫组织化学

    [中图分类号] R55 [文献标识码] A [文章编号] 1673-7210(2017)08(c)-0189-04

    [Abstract] Vascular follicular lymphadenopathy， also known as Castleman 's Disease (CD)， giant lymph node hyperplasia， it is a rare cause of chronic lymphoproliferative dysplasia， mainly characterized by chronic progressive lymphadenopathy. The disease misdiagnosis rate is higher， the diagnosis depends on pathological examination. The case is a 46-year-old male patients， due to physical examination found mediastinal lumps a year， newly diagnosed as "posterior mediastinal tumor； teratoma？"， intended thoracoscopic assisted mediastinal tumor resection. Because the surgery is difficult to remove lumps， bleeding more， the surgery decided to thoracotomy and successful removal of the mass. Postoperative pathology of vascular follicular lymphadenopathy ......