Abdominal Castleman's Disease: Five Cases Report And Clinical Analysis

BACKGROUND & OBJECTIVE:Castleman's disease,also know as angiofollicular lymph node hyperplasia or giant lymph node hyperplasia, is an uncommon and easily misdiagnosed, lymphoproliferative disorder that can affect any lymph nodes,usually occur in mediastinum,abdominal and pelvic cavity. This study report 5 cases of abdominal Castleman's disease and review literatures to improve its diagnosis,treatment and prognosis.METHODS:Retrospectively analysis of 5 patients histopathologically diagnosed of abdominal Castleman's disease admitted to our hospital from 2006.1.1 to 2011.3.1.Combined with literature review.RESULTS:In the 5 cases, there are 2 males and 3 females, the onset age are ranging from 24 to 61 with an average age of 48.6. Only 1 case presented abdominal discomfort and had a 20-year history of anemia,the other 4 are all discovered by medical examination and had no significant or specific pre-operation routine laboratory tests. CT scan mostly show a well defined lower density, round or oval mass that can be unevenly enhanced. All 5 patients received lumpectomy and diagnosed by pathology, 2 are hyaline vascular variant and 3 are plasma cell variant. Till now, all 5 patients are alive.CONCLUSIONS:Castleman's disease is rare and because of its lack of specific clinical symptom and imaging and laboratory manifestation, it can be easily misdiagnosed. With stagnant progress on the study of the tumor maker, the precise diagnosis still rely on histopathological examination. Localized Castleman's disease can be cured by complete surgical resection while Multicentric Castleman's disease can only receive little effect through operation, so the major treatment of Multicentric Castleman's disease still follow the rules of lymphoplasia disease:chemotherapy and radiation,but the results are not very good, and other drugs like immune modulators, monoclonal antibodies, antiviral agents etc. seem to have a bright future but still need a lot clinical trials.