血管塞栓術施行後に摘出したCastleman病

Surgical Treatment to Castleman’s Disease after Embolization of Feeding Vessels

Castleman病（CD）は病変の分布により単中心性（unicentric CD：UCD）と多中心性（multicentric CD：MCD）に，病理学的には硝子血管型（HV型）と形質細胞型（PC型）に分類される．UCDは外科的切除が第一選択とされる1）が，HV型では剝離に際して止血に難渋することがある1）．われわれは，術前の血管塞栓が術中出血コントロールに有用であったHV型UCDの1例を経験したため，文献的考察を加え報告する．

A 48-year-old woman with an abnormal shadow on chest X-ray was referred to our institution. Contrast-enhanced chest computed tomography （CT） showed a large mass, 4.4 cm in diameter, in the right upper mediastinum. Castleman’s disease was suspected, and several vessels flowing into the tumor were identified. Since severe intraoperative bleeding was expected, preoperative embolization of the feeding vessels was performed, followed by thoracotomy and tumor extirpation. The amount of blood loss was 50 ml. The pathological diagnosis was Castleman’s disease, hyaline vascular type.