Doença de Castleman associada a derrame pleural

Pinheiro, Valéria Goes Ferreira; Fernandes, Geórgea Hermógenes; Cezar, Lia Cavalcante; Alves, Newton de Albuquerque; Menezes, Dalgimar Beserra de

doi:10.1590/s1806-37132008000800014

Cited by 5 publications

(4 citation statements)

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“…Mass in various locations [ 4 - 6 , 32 - 34 ], pleural effusion [ 12 , 35 ], bronchiolitis [ 9 , 14 , 36 ] and diffuse lung shadows [ 6 , 15 , 23 , 24 ] had been reported in cases with intrathoracic CD. Although masses could be found in the hilum [ 6 ], mediastinum [ 6 , 37 - 39 ], intercostal spaces [ 4 , 5 , 40 ], pleura [ 12 ], chest wall [ 32 , 33 ], trachea [ 8 , 34 ], lungs [ 6 , 41 ], et al, most of the reported masses were located in the hilum or mediastinum, and there was only rare case report(s) showing masses in other intrathoracic places.…”

Section: Discussionmentioning

confidence: 99%

“…Some rare case reports and the analysis of HIV-infected CD cases showed unilateral or bilateral effusions [ 12 , 23 , 24 , 35 , 42 ]. In the case reports the effusion was exudative [ 12 , 35 ] or chylous [ 42 ], but there was no effusion tests for HIV-infected CD cases [ 23 , 24 ]. Lesions originating from or involving the chest wall or pleura, impaired drainage of lymphatic fluids because of the compression caused by CD mass or lymphadenopathy, and/or hypoalbuminia could be the causes of pleural effusions in CD cases.…”

Section: Discussionmentioning

confidence: 99%

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Clinical spectrum of intrathoracic Castleman disease: a retrospective analysis of 48 cases in a single Chinese hospital

Luo

Huang

et al. 2015

BMC Pulm Med

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BackgroundThorax is the common place to develop Castleman disease (CD), but there is no systemic clinical analysis for intrathoracic CD.MethodsWe conducted a retrospective analysis of 48 intrathoracic CD patients with definite pathological diagnosis who were hospitalized between 1992 and 2012 in a Chinese tertiary referral hospital.ResultsThe study included 16 cases with unicentric CD (UCD) and 32 cases with multicentric CD (MCD). UCD were younger than MCD (30.5y vs 41.6ys, P < 0.05). MCD were more symptomatic (50% vs 96.9%, P < 0.001) and sicker than UCD, including more fever, hepatomegaly and/or splenomegaly and hypoalbuminemia. All of UCD showed solitary mass in various sites and two of them were complicated by small pleural effusion. In the MCD group, their chest CT showed obvious lymphadenopathy in the hilum and/or mediastinum (100%), diffuse parenchymal lung shadows (43.75%), pleural effusion (40.6%), mass in the mediastinum (6.25%) or hilum (3.12%) and bronchiolitis obliterans (BO) (3.12%). Besides LIP-like images, multiple nodules of different size and sites, patchy, ground-glass opacities and consolidation were showed in their chest CT. Surgery were arranged for all UCD for diagnosis and treatment and all were alive. In MCD group, superficial lymph nodes biopsies (21 cases), surgery biopsy (9 cases) and CT-guided percutaneous lung biopsy (2 cases) were performed. Hyaline vascular (HV) variant were more common in the UCD group (75% vs 37.5%, P < 0.05). In MCD group, 28 cases were prescribed with chemotherapy, one refused to receive therapy and the rest three were arranged for regular follow-up. Among MCD, 18 cases was improved, 7 cases was stable, 4 cases lost follow-up and 3 cases died.ConclusionsIntrathoracic MCD was more common than UCD in our hospital. MCD was older, more symptomic and sicker than UCD. HV variant were more common in UCD. All of UCD showed mass in various intrathoracic locations and surgery resection was performed for all and all were alive. Mass, pleural effusion, BO and diffuse pulmonary shadows, including LIP-like images, multiple nodules of different size and sites, patchy, GGO and consolidations were showed in our MCD. Most of MCD cases were arranged with chemotherapy and their prognosis were worse than UCD’s.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical spectrum of intrathoracic Castleman disease: a retrospective analysis of 48 cases in a single Chinese hospital

Luo

Huang

et al. 2015

BMC Pulm Med

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“…In particular, the possibility of tuberculous pleurisy due to elevated levels of adenosine deaminase was considered, further complicating the diagnosis [ 9 , 10 ]. This highlights the importance of continually investigating refractory and recurrent cases of pleural effusion [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Castleman Disease in an Older Patient With the Onset of Right Pleural Effusion

Takao,

Matsushima,

Matsumoto

et al. 2023

Cureus

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Castleman’s disease (CD) is an uncommon lymphoproliferative disorder with various presentations in different age groups. Although CD predominantly affects younger individuals, cases in older people are rare. The presentation of CD can range from asymptomatic to severe. We present the case of a 91-year-old male who reported dyspnea and was subsequently diagnosed with right-sided pleural effusion. The patient’s condition deteriorated despite an initial provisional diagnosis of tuberculous pleurisy and multiple interventions. A cervical lymph node biopsy later revealed a diagnosis consistent with the plasma cell type of CD. Considering the patient’s age and atypical presentation, this case adds a unique perspective to the limited literature on CD in elderly patients. Its presentation can be highly variable, and pleural effusion is rare. Our case highlights the heterogeneity of CD presentation, particularly in older age groups. The diagnosis of CD requires high suspicion, particularly in non-traditional populations. Clinicians should be aware of the varied presentations of CD, including in older patients. Unexplained pleural effusion, even in older patients, should prompt a broad differential diagnosis, including rare conditions such as CD.

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“…O diagnóstico dessa morbidade é feito pelo anatomopatológico associado ao perfil imuno-histoquímico. O tratamento difere quanto às síndromes clínicas: em caso da forma sistêmica, a quimioterapia é comumente associada a corticoisteróides e já na forma localizada, a cirurgia pode ser curativa (PINHEIRO et al, 2008) A toracotomia é a cirurgia comumente realizada para ressecção ou biópsia de massas mediatinais. Nela é mandatório um bom suporte analgésico pós-operatório devido ao estimulo álgico do trauma cirúrgico, pela limitação ventilatória imposta e pela compressão intercostal provocada pelos drenos ou estimulação pleural dos mesmos (MANICA, 2018).…”

Section: Introductionunclassified

Anestesia combinada em tocarotomia para Doença de Castleman: um relato de caso

Rodrigues¹,

Barbosa²,

Palotti³

2022

Braz. J. Hea. Rev.

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As massas mediastinais, principalmente massas de mediastino anterior ou superior, são problemas ímpares para o anestesiologista, segundo Miller et. A toracotomia requer um plano anestésico complexo que contemple uma analgesia multimodal duradoura. O trabalho teve como objetivo analisar o perfil de uma paciente com Doença de Castleman mediastinal com necessidade de toracotomia associada a anestesia epidural. Essa paciente possui sexo feminino, 39 anos, ASA II por hipertensão arterial, que apresentava uma massa mediastinal superior a esquerda com proximidade a grandes vasos. Ela foi submetida à toracotomia sob anestesia geral associada a peridural com passagem de cateter e controle de analgesia pós-operatória no mesmo. A anestesia peridural ainda é padrão-ouro para toracotomias, demonstrando incidência baixa de complicações e bons resultados analgésicos e de morbimortalidade. Dessa forma, a indicação do bloqueio peridural alto é de destaque para algumas cirurgias.

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Doença de Castleman associada a derrame pleural

Cited by 5 publications

References 15 publications

Clinical spectrum of intrathoracic Castleman disease: a retrospective analysis of 48 cases in a single Chinese hospital

Clinical spectrum of intrathoracic Castleman disease: a retrospective analysis of 48 cases in a single Chinese hospital

Castleman Disease in an Older Patient With the Onset of Right Pleural Effusion

Anestesia combinada em tocarotomia para Doença de Castleman: um relato de caso

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