[Local Castleman's disease: a report of 17 cases with literature review]

Abstract

Background & objective: Castleman's disease (CD), also named angiofollicular lymph node hyperplasia or giant lymph node hyperplasia, is an uncommon reactive lymphadenopathy with unknown causes. This study was to report clinical features and therapeutic outcomes of 17 cases of local Castleman's disease (LCD), review literatures to improve the diagnosis and management of CD.

Methods: Clinical data of 17 LCD patients, treated in Cancer Center of Sun Yat-sen University from Aug. 1995 to Jul. 2006, were reviewed.

Results: There were 3 cases with and 14 cases without clinical symptoms. A single lymph node or aggregation of multiple lymph nodes was observed in a single location. The longest diameters of involved lymph nodes ranged from 1.2 to 10.4 cm. The lesions were located in the neck (11 cases), mediastinum (3 cases), lung (1 case), mesentery (1 case), adrenal region (1 case). Fifteen cases were hyaline vascular type, 1 case was plasma cell type and 1 case was mixed type; all were confirmed pathologically. One hyaline vascular type LCD patient had splenomegaly, hypoalbumin (25.6 g/L), hyperglobulin (80.0 g/L) and positive fecal occult blood. One plasma cell type LCD patient had anemia (95.0 g/L), positive urine protein and positive fecal occult blood. The other 15 patients had normal laboratory results. All patients underwent complete surgical resection. The duration of follow-up ranged from 1 to 129 months with a median of 25 months. Fifteen followed-up patients were all alive without recurrence.

Conclusions: LCD patients mainly have lymphadenectasis in a single location, no clinical symptoms and normal laboratory results, with a majority of hyaline vascular type. Although CT is helpful for the diagnosis of LCD, the final diagnosis depends on pathologic examination. LCD patients can live long without recurrence after complete surgical resection of the tumor.