Intrathoracic Castleman's disease: “An important clinical mimicker”

Takhar, Rajendra Prasad

doi:10.4103/lungindia.lungindia_419_15

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…Despite the rarity of CD, we have accumulated a set of diverse cases that enabled a comprehensive review of the diagnosis and therapeutic options available for this disorder. Furthermore, this study demonstrates the significance of including CD in the differential diagnosis of other diseases because it continues to earn its reputation as a "clinical mimicker" and is often (especially with the UCD variant) misdiagnosed or undiagnosed (1,2,(36)(37)(38). After histopathological examination, which remains the only method of obtaining a certain diagnosis of this disease, we identified all three histological types of CD among our cases.…”

Section: Discussionmentioning

confidence: 71%

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Clinicopathological comparison and therapeutic approach to Castleman disease—a case-based review

Wojtyś¹,

Piekarska²,

Kunc

et al. 2019

J Thorac Dis

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Castleman disease (CD) is a rare, B-cell lymphoproliferative disorder affecting lymph nodes and extranodal anatomical locations. Four types of clinical presentations can be distinguished after exclusion of mimics. The first division is into unicentric CD (UCD) and multicentric CD (MCD). MCD is classified further as HHV-8-negative (idiopathic), MCD associated with HHV-8 infection, and POEMS associated MCD. From the histological standpoint, UCD and MCD can be classified as hyaline-vascular (HV), plasma cell (PC), or mixed cellularity (MC) type, with a spectrum of histopathological manifestations. We present clinical and histopathological features and grading of 25 cases of CD classified according to CDCN histological criteria and according to this clinical algorithm, along with outcomes. Here we provide a fineresolution description of the histological features of CD. We review and discuss the current diagnostic algorithm, grading system, and recently recommended treatment options. In the presented group of 25 patients with CD there were 14 women and 11 men in the age range 15-79 years. UCD was identified in 15 patients and it was most often located in mediastinum. MCD most frequently occurred as generalized lymphadenopathy. The most common type of CD was HV. All patients with UCD underwent complete surgical resection with a positive outcome. Patients with MCD had diagnostic partial surgical excision of the lesions, later followed by different types of treatment (corticosteroids, chemotherapy, radiotherapy, immunomodulatory agents) or 'watch and wait'. In four cases CD was associated with other malignancies (laryngeal cancer, small lymphocytic lymphoma, gallbladder cancer with hepatic metastases, primary squamous cell lung cancer). The accuracy of histopathological examination is essential and re-evaluation has to be performed in case of relapse or unexpected course of CD. Treatment tailored to fit the disease type and severity should follow the novel recommendations, including anti-IL-6 treatment in the case of MCD.

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Section: Discussionmentioning

confidence: 71%

“…Castleman's disease (CD), also known as giant lymph node hyperplasia or angiofollicular lymphoid hyperplasia, is a benign lymphoproliferative disorder affecting both lymph nodes and extranodal loci (1,2). With an occurrence rate of 21 to 25 cases per million person-years, it is classified as an orphan disease.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological comparison and therapeutic approach to Castleman disease—a case-based review

Wojtyś¹,

Piekarska²,

Kunc

et al. 2019

J Thorac Dis

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“…Castleman disease is a rare and heterogeneous group of diseases, characterized by non-clonal lymphoproliferation. [7] Unicentric disease (UCD) usually presents in young adults with localized masses. In contrast, Multicentric Castleman's Disease (MCD) commonly presents in the age group of fifth to sixth decade with diffuse lymphadenopathy and is frequently associated with multi-organ involvement and systemic inflammatory symptoms.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Presentation of Idiopathic Multicentric Castleman Disease: The Great Masquerader

Mazumder

Naidu

Cherian

et al. 2020

Ann of Pathol and Lab Med

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Castleman disease is an uncommon, non-clonal, lymphoproliferative disorder characterized by lymphadenopathy and symptoms related to hypercytokinemia. Clinically it is classified as unicentric and multicentric disease. Multicentric disease is further subclassified as HHV- 8 associated disease and idiopathic disease, which is the rarest subtype. The incidence of idiopathic disease is estimated to be 5 per million person years. The diagnosis of Idiopathic Multicentric Castleman disease is complicated by an array of clinical mimics and non-specific symptoms. We report a rare case of Idiopathic Multicentric Castleman disease in a young female where a detailed pathological work up helped to secure the diagnosis and exclude its mimics.

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