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Case Reports
. 2020:73:332-337.
doi: 10.1016/j.ijscr.2020.07.049. Epub 2020 Jul 18.

Castleman disease. Interaction with dermatopathy: Case report

M L A Modolin  1 , C P Camargo  2 , D A Milcheski  1 , W Cintra Jr  1 , R I Rocha  1 , G M Clivatti  1 , B Nascimento  1 , R Gemperli  3
Affiliations
Case Reports

Castleman disease. Interaction with dermatopathy: Case report

M L A Modolin et al. Int J Surg Case Rep. 2020.

Abstract

Introduction: Castleman disease (CD) is a lymphoproliferative disorder with lymph node hypertrophy. In the unicentric form (UCD), it affects one lymph node or chain of lymph nodes. In the multicentric form (DCM), there is hypertrophy of several lymph node chains with the formation of tumor masses, causing compressive symptoms. This case report showed a case of CD in a different location(inguinal region) associated to a multiple skin lesions.

Presentation of the case: We reported a UCD in a 43-year-old female patient with no previous comorbidities. Since January 2016, this patient developed erysipelas lesions of the left leg (LL) from the thigh root to the foot. Concomitantly, a tumor mass appeared in the inguinal region. In 2019 we performed a biopsy that revealed changes characteristic of CD. Due to extremely poor trophic conditions, the skin area with erysipelas was resected, and the raw surface was grafted.

Discussion: As an inference, the erysipelas may have been responsible for the subsequent lymphangitis, lymphedema and lymph node hypertrophy.

Conclusion: Resection of the diseased skin and lymph node excision constitute the treatment of UCD and result in improvement of the clinical picture. Nevertheless, further study of the inflammatory reaction and of markers such as interleukin-6 and the presence of skin disorders in DC is needed.

Keywords: Castleman disease; Lymphedema; Skin wound; Wound.

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Figures

Fig. 1
Fig. 1
Lesion with lymphedema in the left leg. Lateral views.
Fig. 2
Fig. 2
PET SCAN showing: Skin thickening associated with densification of the subcutaneous plane of the left leg; Lymph nodes and lymph node enlargement in the left femoral and inguinal chains.
Fig. 3
Fig. 3
MRI showing the plane of the intact muscle fascia.
Fig. 4
Fig. 4
Left leg after resection of the lesion.
Fig. 5
Fig. 5
Left leg after skin grafting.
Fig. 6
Fig. 6
Microscopic examination of the lymph node (40× magnification). Lymphoid follicles with atretic germinative centers. Concentric rings of lymphocytes in an “onion skin” pattern.
Fig. 7
Fig. 7
Patient’s follow-up (six months).
See this image and copyright information in PMC

References

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