Castleman's Disease with Cutaneous Involvement Manifestating as Multiple Violaceous Plaques on Entire Body

Abstract

Castleman's disease (CD) is an uncommon B-cell lymphoproliferative disorder characterized by lymph node hyperplasia with vascular proliferation. Cutaneous involvement in CD is rare. A 65-year-old man presented with a 7-year history of gradually developing multiple reddish to violaceous indurated plaques on the scalp, trunk, and legs. On physical examination, there were palpable enlarged cervical, axillary, and inguinal lymph nodes. Laboratory examination revealed anemia, thrombocytosis, hyperproteinemia, hypoalbuminemia, and polyclonal hypergammaglobulinemia. An inguinal lymph node biopsy and a skin biopsy were performed and the patient was diagnosed with the plasma cell type of CD. Chemotherapy was started and the lesions have responded to treatment.

Late‐onset skin involvement on the forehead in multicentric Castleman disease

“…Regarding epidemiologic features of published cases in kidney recipients (5/8), two patients had an explicit exposure to wound and agricultural environment. 2,4 Similar to our case, three of these five articles described a solitary lesion on lower limbs in the form of papule, plaque, or tumor, [3][4][5]…”

“…1 MCD is sometimes associated with skin involvement, and in such cases, the clinical and histologic features overlap with cutaneous and systemic plasmacytosis. 2,3 The skin lesions manifest as multiple erythematous to brownish plaques or nodules predominantly on the trunk and face. 2,4,5 The histologic finding of the cutaneous involvement was perivascular infiltration with plasma cells.…”

“…2,3 The skin lesions manifest as multiple erythematous to brownish plaques or nodules predominantly on the trunk and face. 2,4,5 The histologic finding of the cutaneous involvement was perivascular infiltration with plasma cells. In our case, the skin lesions were slightly depressed and localized to the forehead; therefore, we clinically suspected the macules to be lupus profundus, lipoatrophy, postinflammatory pigmentation, or scleroderma.…”

“…1d) (Table 1). [1][2][3][4][5][6][7][8] Surprisingly, all of them were reported in European countries and affected patients with history of renal (5), 1-5 liver (2), 6,7 or lung (1) 8 transplantation. Regarding epidemiologic features of published cases in kidney recipients (5/8), two patients had an explicit exposure to wound and agricultural environment.…”

Co-existence of multicentric Castleman′s disease and Kaposi′s sarcoma

“…[ 8 ] Castleman's disease is histologically divided into three types: Hyaline vascular type or angiofollicular type, plasma cell (PC) type, and mixed type. [ 9 ]…”