rospedjРоссийский педиатрический журналRussian Pediatric Journal2687-0843Издательство «ПедиатрЪ»10.15690/rpj.v5i4.2836rospedj-777Research ArticleОРИГИНАЛЬНАЯ СТАТЬЯORIGINAL INVESTIGATIONSОбзор литературы и серия клинических наблюдений болезни Кастлемана у детейLiterature Review and a Series of Cinical Cases of Castleman’s Disease in Childrenhttps://orcid.org/0000-0002-8983-0670НаумоваА. С.NaumovaAleksandra S.

Наумова Александра Сергеевна, кандидат медицинских наук, врач детский онколог консультативно-диагностического центра,

119571, г. Москва, Ленинский пр-т, д. 17.

Телефон: +7 (906) 074-68-92

РАСКРЫТИЕ ИНТЕРЕСОВ: Авторы статьи подтвердили отсутствие конфликта интересов, о котором необходимо сообщить.

Aleksandra S. Naumova, MD, PhD,

17, Leninsky Prospekt, Moscow, 119571. Phone:  +7 (906) 074-68-92.

DISCLOSURE OF INTEREST: Not declared.

alex.naumova@gmail.comhttps://orcid.org/0000-0002-1469-2365ВалиевТ. Т.ValievTimur T.

Валиев Тимур Теймуразович, д.м.н.,

Москва; Москва.

РАСКРЫТИЕ ИНТЕРЕСОВ: Авторы статьи подтвердили отсутствие конфликта интересов, о котором необходимо сообщить.

Timur T. Valiev, MD, PhD,

Moscow; Moscow.

DISCLOSURE OF INTEREST: Not declared.

timurvaliev@mail.ruРоссийская детская клиническая больница — филиал ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава РоссииРоссияRussian Pediatric Clinical HospitalRussian FederationНИИ ДОИГ им. акад. РАМН Л.А. Дурнова; Первый МГМУ им. И.М. Сеченова (Сеченовский Университет)РоссияN.N. Blokhin National Medical Research Center of Oncology; I.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation20242512202454173181Copyright © Наумова А.С., Валиев Т.Т., 20242024Наумова А.С., Валиев Т.Т.Naumova A.S., Valiev T.T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rospedj.ru/jour/article/view/777

Обоснование. Болезнь Кастлемана (БК) у детей представлена, как правило, локальной формой и гиалиново-васкулярным морфологическим вариантом. Выбор терапевтических опций затруднен в связи с отсутствием единых стандартов лечения. С учетом доброкачественного течения цитостатическая терапия не используется. Выбор метода терапии при БК определяется распространенностью патологического процесса. При локальной форме БК показана хирургическая резекция пораженных лимфатических узлов, при неэффективности хирургического лечения рассматривается лучевая терапия. Описание клинических наблюдений. В 2011–2024 гг. под наблюдением находились 9 пациентов в возрасте от 1 года до 17 лет с морфологически верифицированной уницентрической болезнью Кастлемана. Всем пациентам выполнена инцизионная биопсия, гиалиново-васкулярный вариант диагностирован у 6 пациентов, плазмоклеточный вариант — у 3 пациентов. Длительность анамнеза заболевания составила 2–56 мес, длительность наблюдения за больными — от 4 до 124 мес. Рецидив заболевания после проведения первичного оперативного лечения развился в единственном случае. Заключение. Лимфаденопатии и различные варианты гиперплазии лимфоидной ткани традиционно представляют сложности для диагностики в практической работе педиатра, поскольку могут быть проявлениями широкого спектра инфекционных, воспалительных, иммунных и опухолевых заболеваний. Особое место в большом перечне патологий, сопровождающихся увеличением лимфатических узлов, занимают редкие заболевания, к которым относится БК. Для своевременной и правильной диагностики БК необходимы детальный анализ анамнеза, применение инструментальных методов диагностики для оценки распространенности патологического процесса и обязательна морфологическая верификация диагноза.

Background. Castleman’s disease (CD) in children is represented, as a rule, by a local form and a hyaline-vascular morphological variant. The choice of therapeutic options is difficult due to the lack of uniform treatment standards. Given the benign course, cytostatic therapy is not used. The choice of treatment method for patients with CD in most cases is determined by the prevalence of the process. In case of local form of CD, surgical treatment is carried out in the scope of radical removal of the affected lymph nodes; if surgical treatment is ineffective, radiation therapy is considered. Clinical observations description. In 2011–2024 it was observed 9 patients aged 1 to 17 years with morphologically verified unicentric CD. All patients underwent incisional biopsy; the hyaline-vascular variant was detected in 6 patients, and the plasma cell variant — in 3 patients. The duration of the medical history was 2–56 months. Relapse of the disease after primary surgical treatment occurred in a single case. Conclusion. Lymphadenopathy and various types of lymphoid hyperplasia are traditionally difficult in differential diagnosis in the practical work of a pediatrician, since it can be manifestations of a wide range of infectious, inflammatory, immune and malignant diseases. A special place in the large list of pathologies accompanied by enlarged lymph nodes is occupied by rare diseases, which include CD. For timely and correct CD diagnosis it is necessary to analyze the anamnesis, use an instrumental method for disease dissemination study and necessary a morphologic verification.

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The authors declare that there are no conflicts of interest present.