Multi-disciplinary diagnosis and treatment for a case of idiopathic multicentric Castelman disease
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摘要: 本文介绍了1例特发性多中心Castleman病(iMCD)患者经多学科联合诊疗(MDT)讨论，最终明确诊断，并得到合适治疗的过程。患者以多浆膜腔积液起病，诊治过程中发现患者全身淋巴结肿大，同时合并血液系统、肾脏、内分泌多系统损害，于外院行胸腹水检查未发现病原学及肿瘤相关证据，自身免疫性疾病相关指标异常但未达相关免疫性疾病分类标准，淋巴结穿刺仅提示反应性淋巴结增生，明确诊断前，整个诊疗过程长达2个月。最终患者经我院MDT讨论，完善淋巴结活检，结合病理科和多个临床学科专家意见，诊断为iMCD，随后得到恰当治疗方案，情况好转。该患者的诊治过程体现了MDT在罕见病iMCD明确诊断的过程中发挥着重要作用，同时有助于患者及时得到精准有效的治疗，显著改善患者的结局。
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关键词:
- Castleman病 /
- 淋巴结肿大 /
- 司妥昔单抗 /
- 多学科联合诊疗
Abstract: This article introduces the process of a case with idiopathic multicentric Castleman disease(iMCD) ultimately diagnosed and appropriately treated after multi-disciplinary team(MDT) discussion. The patient presented with multiple serous cavity effusions onset and was found to have generalized lymphadenopathy accompanied by multisystem damage including the blood, kidneys, and endocrine system. Examinations of the pleural and abdominal fluids at other hospitals did not reveal any etiological or tumor-related evidence. Indicators of autoimmune diseases were abnormal but did not meet the classification criteria for related autoimmune diseases. Lymph node puncture biopsy only suggested reactive hyperplasia. The entire diagnostic and treatment process took as long as 2 months before a confirmed diagnosis. Ultimately, the patient underwent an excisional lymph node biopsy and was diagnosed with iMCD through our hospital's MDT discussion with experts from pathology and multiple clinical departments. Subsequently, the patient received an appropriate treatment plan and got condition improved. The diagnosis and treatment process of this case demonstrates that MDT plays an important role in the differential diagnosis of the rare disease iMCD and it can also help patients by receiving timely, precise, and effective treatment, thus significantly improving their outcomes.-
Key words:
- Castleman disease /
- lymphadenopathy /
- Siltuximab /
- multi-disciplinary team
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