Multicentric Castleman’s Disease, Associated with Idiopathic Thrombocytopenic Purpura

Abstract

The most common cause of a neck mass in young adults is hyperplastic lymphadenopathy consequent to infection and inflammation. Castleman's disease (CD), an unusual benign lymphoproliferative disorder, infrequently causes neck masses. It occurs in unicentric (UCD) and multicentric (MCD) forms and is associated with human immunodeficiency virus (HIV), human herpes virus 8 (HHV-8), and Kaposi's sarcoma. We present the third known association between MCD and previous immune thrombocytopenia in the absence of HIV and HHV-8 infection and review its association with other autoimmune disorders and attendant implications for pathogenesis. Finally, we summarize the current approach to therapy.

General anesthesia in a patient with multicentric Castleman's disease: a case report

“…CD is typically presents as a mediastinal mass and primarily involves the lymphatic tissue, but it may also occur in virtually any area of the organism (the neck, axilla, larynx, parotid gland, lungs, retroperitoneum, mesentery, kidney, pancreas, pelvic cavity, muscle, pericardium, central nervous system [CNS] and vulva) [ 5 , 7 , 11 ]. UCD is the most common form of CD; it is confined to a single lymph node chain or area, is usually the HV type, and is often asymptomatic.…”

“…If there is any infiltration in the neck, larynx, or parotid gland or if the patient is accompanied with steroid-induced facial-truncal obesity, intubation could be difficult and cause danger in ventilation. Therefore, experienced staff and the proper equipment must always be immediately available [ 3 , 7 , 11 ].…”

“…Accordingly, cisatracurium was chosen for muscle relaxation. On rare occasions, CD is associated with myasthenia gravis, most likely due to possible autoimmune pathology [ 11 ]. Hence, in such cases, muscle relaxants should be used with careful monitoring.…”