Case Report And Literature Review Of Castleman's Disease

Objective: Investigate the clinical and pathological features, diagnosis and treatment of Castleman's disease (CD).Methods: Clinical features and related information about diagnosis and treatment of 18 cases of Castleman's disease from January 2004 to July 2007 were retrospectively analyzed. And we reviewed the related literatures.Results: Eleven cases were female, and the others were male. The ages ranged from 18 to 67 years, and the mean age was 38.6 years. Ten cases were found mass without symptoms, and the others had edema of lower limbs, abdominal pain, chest pain, or chest distress. Two cases had POEMS syndrome. Ten cases with lymph node hyperplasia in a single area were localized Castleman's disease (LCD), and others with lymph node hyperplasia in several areas were multicentric Castleman's disease (MCD). There were nospecific characters of imagelogic and laboratory examination in the eighteen cases. Sixteen cases were hyaline-vascular type the lymph node of which appeared a small, hyalinized follicle surrounded by a cuff of small lymphocytes arranged in concentric "onion skin" layers. Two cases were plasma cell type the lymph node appeared germinal centers with plasma cells in the interfollicular area. The ten cases of LCD underwent excision, without recurrence up. Seven cases of MCD were treated with glucocorticoids or combined chemotherapy et al., six of which achieved remission.Conclusion: Castleman disease is a rare and cryptogenic atypical lymphatic tissue disease, which character with lymphatic tissue hyperplasia in the follicular and interfollicular area. Under pathologic examination, some appear as small, hyalinized follicles surrounded by a cuff of small lymphocytes arranged in concentric "onion skin" layers, some appear as germinal centers with plasma cells in the interfollicular area. There were nospecific characters of clinical symptoms, imagelogic and laboratory examination in Castleman's disease and it's usually misdiagnosed. The final diagnosis depends on pathologic proof. The patients of LCD would be cured with excision, while the patients of MCD would achieve remission by glucocorticoids or combined chemotherapy.