Multicentric Castleman’s disease presenting with multiple nodes in lungs: a case report and literature review

Sun, Xuguo; Han, Bing

doi:10.1007/s12185-008-0146-8

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…Interestingly, 2 of them predominantly had lung abnormalities. Although the clinical presentation is atypical for iMCD, similar cases have been reported [ 7 , 8 ]. These cases did not meet the diagnostic criteria for iMCD because lymphadenopathy at multiple sites is essential for the diagnosis [ 13 ].…”

Section: Discussionsupporting

confidence: 52%

Idiopathic multicentric Castleman's disease: a clinicopathologic study in comparison with IgG4-related disease

et al. 2018

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The present study aimed to compare clinicopathologic features between idiopathic multicentric Castleman's disease (n=22) and IgG4-related disease (n=26). Histology was analyzed using lymph node and lung biopsies. The expression of IL-6 mRNA in tissue was also examined by in situ hybridization and real-time PCR. Patients with idiopathic multicentric Castleman's disease were significantly younger than those with IgG4-related disease (p<0.001). Splenomegaly was observed in only idiopathic multicentric Castleman's disease (p=0.002), while pancreatitis and sialo-dacryoadenitis were restricted to IgG4-related disease (both p<0.001). Serum IgG4 concentrations were commonly elevated at >135 mg/dL in both groups (p=0.270). However, the IgG4/IgG ratio in IgG4-related disease was significantly higher than that in Castleman's disease (p<0.001). Histologically, sheet-like plasmacytosis was highly characteristic of idiopathic multicentric Castleman's disease (p<0.001), while plasmacytic infiltration in IgG4-related disease was always associated with intervening lymphocytes. Similar to laboratory findings, the IgG4/IgG-positive plasma cell ratio, but not the IgG4-positive cell count, was significantly higher in IgG4-related disease (p=0.002). Amyloid-like hyalinized fibrosis was found in 6/8 lung biopsies (75%) of Castleman's disease. The over-expression of IL-6 mRNA was not confirmed in tissue samples of Castleman's disease by either in situ hybridization or quantitative real-time PCR. In conclusion, useful data for a differential diagnosis appear to be age, affected organs, the serum IgG4/IgG ratio, sheet-like plasmacytosis in biopsies, and the IgG4/IgG-positive cell ratio on immunostaining. Since IL-6 was not over-expressed in tissue of idiopathic multicentric Castleman's disease, IL-6 may be produced outside the affected organs, and circulating IL-6 may lead to lymphoplasmacytosis at nodal and extranodal sites.

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Section: Discussionsupporting

confidence: 52%

Idiopathic multicentric Castleman's disease: a clinicopathologic study in comparison with IgG4-related disease

et al. 2018

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“…Common radiological pulmonary findings noted in Castleman's disease are diffuse bilateral interstitial pneumonitis with bilateral reticular opacities, bronchovascular thickening and sub pleural nodules, accompanied by dyspnea, cough, fever and lymphadenopathy night sweats and weight loss. Pleural effusions, isolated mediastinal lymphadenopathy, solitary and multiple pulmonary nodules as the presenting feature of MCD have also been described [8][9][10].…”

Section: Discussionmentioning

confidence: 97%

An unusual presentation: A case of Multicentric Castleman's disease presenting as bilateral pleural effusions

et al. 2015

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“…[ 1 ] After Barrie et al [ 13 ] reported on MCD-DPLDs, they have been discussed occasionally. [ 1 , 5 , 14 – 16 ] In the reported cases of non-HIV MCD-DPLDs, LIP-like patterns are the most commonly reported, either in radiological or pathological studies. [ 4 , 5 , 13 , 14 ] However, this same trend was not found in our enrolled CD patients.…”

Section: Discussionmentioning

confidence: 99%

Castleman disease-associated diffuse parenchymal lung disease

Huang¹,

Feng

Li³

et al. 2017

Medicine

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Intrathoracic involvement is common in Castleman disease (CD), but CD-associated diffuse parenchymal lung disease (DPLD) is rare and not well-reported.We conducted a retrospective analysis of 262 CD patients with a definite pathological diagnosis who were hospitalized between 1999 and 2015.Twenty-two CD patients had DPLD based on chest computed tomography (CT) scans. Among them, 9 were male and 13 were female, with a mean age of 45.3 years. Coughing (72.7%), fever (68.2%), and dyspnea (59.1%) were the common clinical manifestations. In high-resolution CT, obvious lymphadenopathy (81.8%) was the most frequent, followed by multiple nodules of different sizes (72.7%), cysts (59.1%), and patches of ground-glass opacity (54.5%). Six patients had lymphocytic interstitial pneumonia (LIP)-like CT images. Superficial lymph node biopsies (63.6%), video-assisted thoracic surgery lung biopsies (27.3%), CT-guided percutaneous lung biopsies (9.1%), and endoscopic lymph node biopsies (9.1%) were performed to make final diagnoses. The hyaline vascular variant (27.3%), the plasma cell variant (63.6%), and the mixed variant (9.1%) were the pathological subtypes. All but 2 were prescribed chemotherapy, and none was administered anti-interleukin-6 therapy. Among them, 14 patients improved, 3 died, 2 were stable, 2 were refractory, and 1 was lost to follow-up.Chinese CD-associated DPLD might be more prevalent in middle-aged female patients, with most cases being the plasma cell variant. Although a LIP-like pattern was reported, only one-quarter of the patients showed LIP-like CT images. Multiple nodules (especially solid nodules), cysts, and patchy areas were the common pulmonary radiological findings. More than half of the patients improved after chemotherapy. A well-designed prospective study should be performed to confirm these results.

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Multicentric Castleman’s disease presenting with multiple nodes in lungs: a case report and literature review

Cited by 4 publications

References 27 publications

Idiopathic multicentric Castleman's disease: a clinicopathologic study in comparison with IgG4-related disease

Idiopathic multicentric Castleman's disease: a clinicopathologic study in comparison with IgG4-related disease

An unusual presentation: A case of Multicentric Castleman's disease presenting as bilateral pleural effusions

Castleman disease-associated diffuse parenchymal lung disease

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