Idiopathic Multicentric Hyaline Vascular-Type Castleman Disease
Castleman disease is a rare lymphoproliferative disorder presenting with localized or disseminated lymphadenopathy and systemic symptoms. It can be categorized clinically as unicentric or multicentric, histopathologically as hyaline vascular, plasma cell, or mixed variant, and etiologically, conside...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Hindawi Limited
2021-01-01
|
Series: | Case Reports in Hematology |
Online Access: | http://dx.doi.org/10.1155/2021/6620666 |
id |
doaj-9347b7660bdd40349e95e9f1bdeead78 |
---|---|
record_format |
Article |
spelling |
doaj-9347b7660bdd40349e95e9f1bdeead782021-04-26T00:04:55ZengHindawi LimitedCase Reports in Hematology2090-65792021-01-01202110.1155/2021/6620666Idiopathic Multicentric Hyaline Vascular-Type Castleman DiseaseAdelaide Moutinho0Rita Gamboa Cunha1Sheila Koch Jamal2Marta Meleiro Lisboa3Sandra Tavares4Department of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineCastleman disease is a rare lymphoproliferative disorder presenting with localized or disseminated lymphadenopathy and systemic symptoms. It can be categorized clinically as unicentric or multicentric, histopathologically as hyaline vascular, plasma cell, or mixed variant, and etiologically, considering the subtypes based on causative viral agents and associated syndromes. The multicentric type can mimic other haematological malignancies, ranging from asymptomatic to multiple organ involvement. Although its pathophysiology is not well known, the current approved treatments are directed towards interleukin-6, CD-20, and viral agents. The authors present an 82-year-old leucodermic man presented with a 2-week history of constitutional symptoms. Examination revealed pallor, hepatosplenomegaly, and palpable left axillary lymphadenopathy. Investigation showed anaemia, thrombocytopenia, polyclonal hypergammaglobulinemia, hypoalbuminemia, and high acute phase reactants, with image study revealing multiple axillary, mediastinal, inguinal, and pelvic lymphadenopathies. The lymph node biopsy was consistent with hyaline vascular-type Castleman disease without human herpersvirus-8 markers. He started prednisolone with initial improvement evolved poorly on a short term. Castleman disease has a broad spectrum of clinical manifestations, associations, and complications that bring a diagnostic challenge, requiring a multidisciplinary approach. Clinicians should be familiar with its features because proper diagnosis and aggressive targeted treatment are the pillars of proper management of these patients.http://dx.doi.org/10.1155/2021/6620666 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Adelaide Moutinho Rita Gamboa Cunha Sheila Koch Jamal Marta Meleiro Lisboa Sandra Tavares |
spellingShingle |
Adelaide Moutinho Rita Gamboa Cunha Sheila Koch Jamal Marta Meleiro Lisboa Sandra Tavares Idiopathic Multicentric Hyaline Vascular-Type Castleman Disease Case Reports in Hematology |
author_facet |
Adelaide Moutinho Rita Gamboa Cunha Sheila Koch Jamal Marta Meleiro Lisboa Sandra Tavares |
author_sort |
Adelaide Moutinho |
title |
Idiopathic Multicentric Hyaline Vascular-Type Castleman Disease |
title_short |
Idiopathic Multicentric Hyaline Vascular-Type Castleman Disease |
title_full |
Idiopathic Multicentric Hyaline Vascular-Type Castleman Disease |
title_fullStr |
Idiopathic Multicentric Hyaline Vascular-Type Castleman Disease |
title_full_unstemmed |
Idiopathic Multicentric Hyaline Vascular-Type Castleman Disease |
title_sort |
idiopathic multicentric hyaline vascular-type castleman disease |
publisher |
Hindawi Limited |
series |
Case Reports in Hematology |
issn |
2090-6579 |
publishDate |
2021-01-01 |
description |
Castleman disease is a rare lymphoproliferative disorder presenting with localized or disseminated lymphadenopathy and systemic symptoms. It can be categorized clinically as unicentric or multicentric, histopathologically as hyaline vascular, plasma cell, or mixed variant, and etiologically, considering the subtypes based on causative viral agents and associated syndromes. The multicentric type can mimic other haematological malignancies, ranging from asymptomatic to multiple organ involvement. Although its pathophysiology is not well known, the current approved treatments are directed towards interleukin-6, CD-20, and viral agents. The authors present an 82-year-old leucodermic man presented with a 2-week history of constitutional symptoms. Examination revealed pallor, hepatosplenomegaly, and palpable left axillary lymphadenopathy. Investigation showed anaemia, thrombocytopenia, polyclonal hypergammaglobulinemia, hypoalbuminemia, and high acute phase reactants, with image study revealing multiple axillary, mediastinal, inguinal, and pelvic lymphadenopathies. The lymph node biopsy was consistent with hyaline vascular-type Castleman disease without human herpersvirus-8 markers. He started prednisolone with initial improvement evolved poorly on a short term. Castleman disease has a broad spectrum of clinical manifestations, associations, and complications that bring a diagnostic challenge, requiring a multidisciplinary approach. Clinicians should be familiar with its features because proper diagnosis and aggressive targeted treatment are the pillars of proper management of these patients. |
url |
http://dx.doi.org/10.1155/2021/6620666 |
work_keys_str_mv |
AT adelaidemoutinho idiopathicmulticentrichyalinevasculartypecastlemandisease AT ritagamboacunha idiopathicmulticentrichyalinevasculartypecastlemandisease AT sheilakochjamal idiopathicmulticentrichyalinevasculartypecastlemandisease AT martameleirolisboa idiopathicmulticentrichyalinevasculartypecastlemandisease AT sandratavares idiopathicmulticentrichyalinevasculartypecastlemandisease |
_version_ |
1714657580425412608 |