[Clinical analysis on giant lymph node hyperplasia on neck].
OBJECTIVE
To improve the diagnosis and management level of giant lymph node hyperplasia (Castleman's disease).


METHODS
To retrospective analyze 10 misdiagnosed cases with Castleman's disease in order to give some suggestions for clinical diagnosis and differential diagnosis.


RESULTS
Ten patients with neck giant lymph node hyperplasia underwent surgical treatment after misdiagnosis. There were 8 localized Castleman's disease constituted of 6 cases with hyaline vascular type and 2 cases with mixture type and 2 multicentric Castleman's disease constituted of 1 cases with plasma cell type and 1 cases with mixture type were classified according to the criteria described by Frizzera. Ten cases were diagnosed by secondary operation after misdiagnosis and were clinically characterized by painless neck lymphadenectasis, 2 cases with multicentric Castleman's disease accompanied with aspecific systemic symptom and (or) multi-system damage. Ten cases survived for 4 - 17 years during follow-up periods in which 1 case with plasma cell type, multicentric Castleman's disease was recurrent 2 years later and underwent lymphadenectomy and chemotherapy and have no local recurrence so far.


CONCLUSIONS
Castleman's disease on neck is seldom seen and liable to misdiagnose. The diagnosis of Castleman's disease is based on its histopathological characteristics by lymph node resection biopsy. It should be considered in the differential diagnosis with lymph node tuberculosis, lymphadenitis, sarcoidosis and granuloma. Operation is the first choice for patient with localized type and multicentric type without serious involvement of multiple system functions.
Ma
Shi-hong
SH
Department of Head Neck Surgery, Tumor Hospital of Gansu Province, Lanzhou 730050, China. mashihong0901@yahoo.com.cn
Liu
Qin-jiang
QJ
Wang
Jun
J
Yang
Rong
R
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D005871:Castleman Disease / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D012189:Retrospective Studies; D055815:Young Adult