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Montes-Moreno S, Climent F, Fraga M, Luis Patier J, Robles-Marhuenda Á, García-Sanz R, Ocio EM, González García A, Navarro JT. Expert consensus on the integrated diagnosis of idiopathic multicentric Castleman disease. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2023; 56:158-167. [PMID: 37419554 DOI: 10.1016/j.patol.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 07/09/2023]
Abstract
Idiopathic multicentric Castleman disease (iMCD) is rare. The differential diagnosis includes inflammatory, autoimmune and neoplastic disease. The identification of the histopathological features of Castleman disease in the lymph node is the main diagnostic criterion. Fifty-three experts from three medical societies (SEMI, SEHH and SEAP) have created a multi-disciplinary consensus document in order to standardise the diagnosis of Castleman disease. Using the Delphi method, specific recommendations for the initial clinical, laboratory and imaging studies have been made for an integrated diagnosis of iMCD as well as for the best way to obtain samples for histopathological confirmation, correct laboratory procedure and interpretation and reporting of results.
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Affiliation(s)
- Santiago Montes-Moreno
- Servicio de Anatomía Patológica y Laboratorio Hematopatología Traslacional, Hospital Universitario Marqués de Valdecilla/IDIVAL, Centro para la Investigación Biomédica CIBERONC, Santander, Spain.
| | - Fina Climent
- Departmento de Anatomía Patológica, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Máximo Fraga
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Santiago de Compostela, Departamento Forense, Anatomía Patológica, Ginecología, Obstetricia y Pediatría, Facultad de Medicina de Santiago de Compostela, Spain
| | - José Luis Patier
- Unidad de Enfermedades Autoinmune Sistémicas y Minoritarias, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá de Henares, Madrid, Spain
| | | | - Ramón García-Sanz
- Departmento de Hematología, Hospital Universitario de Salamanca, Centro para la Investigación del Cáncer (CiC-IBMCC, CSIC/USAL), Centro para la Investigación Médica CIBERONC, Instituto de Investigación Biomédica de Salamanca (IBSAL), Spain
| | - Enrique M Ocio
- Departamento de Hematologia, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain
| | - Andrés González García
- Unidad de Enfermedades Autoinmune Sistémicas y Minoritarias, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - José-Tomás Navarro
- Laboratorio de Hematología, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Badalona, Instituto para la Investigación de la Leucemia Josep Carreras, Spain
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González-García A, Patier de la Peña JL, García-Cosio M, Sarhane Y, Sánchez Díaz C, Barbolla Díaz I, López Rodríguez M, Moreno MÁ, Villarubia J, Manzano L. Clinical and pathological characteristics of Castleman disease: an observational study in a Spanish tertiary hospital. Leuk Lymphoma 2019; 60:3442-3448. [PMID: 31305183 DOI: 10.1080/10428194.2019.1639168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Castleman disease (CD) represents a heterogeneous group of lymphoproliferative disorders that share well-defined histopathological features. An observational study of patients with CD was conducted. A total of 53 patients had CD: 20 had the unicentric form (UCD) and 33 the multicentric (MCD) variant; 10 of the latter cases were infected with human herpesvirus-8 (HHV-8) and 23 were idiopathic (iMCD). Median age differed between UCD and iMCD (30 vs. 49 years, p = .004). Males were completely predominant in HHV-8-associated MCD (100%), and females were more frequent in UCD (75 vs. 48%, p = .06). Relapses were more frequent in iMCD (57 vs. 10% UCD, p = .002), and mortality was significantly higher in iMCD and the HHV-8-associated form with respect to UCD. We conclude that UCD is a benign disorder of younger ages and female predominance, while iMCD represents a different entity with more disease relapses and higher mortality.
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Affiliation(s)
- Andrés González-García
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain.,Unidad de Enfermedades Sistémicas Autoinmunes y Minoritarias. Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. IRYCIS. Madrid, Spain
| | - José Luis Patier de la Peña
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain.,Unidad de Enfermedades Sistémicas Autoinmunes y Minoritarias. Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. IRYCIS. Madrid, Spain
| | - Mónica García-Cosio
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Yasmina Sarhane
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain
| | - Cristina Sánchez Díaz
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain
| | - Ignacio Barbolla Díaz
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain
| | - Mónica López Rodríguez
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain.,Unidad de Enfermedades Sistémicas Autoinmunes y Minoritarias. Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. IRYCIS. Madrid, Spain
| | - María Ángeles Moreno
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain
| | - Jesús Villarubia
- Servicio de Hematología. Hospital Universitario Ramón y Cajal. IRYCIS. Madrid, Spain
| | - Luis Manzano
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal. Universidad de Alcalá, IRYCIS. Madrid, Spain
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Chronic Myelomonocytic Leukemia following Multicentric Castleman Disease. Case Rep Hematol 2018; 2018:5895903. [PMID: 29607228 PMCID: PMC5828649 DOI: 10.1155/2018/5895903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 12/07/2017] [Indexed: 11/18/2022] Open
Abstract
Multicentric Castleman disease (MCD) is a rare nonmalignant lymphoproliferative disorder presenting systemic symptoms such as fever, night sweats, fatigue, anemia, effusions, and multifocal lymphadenopathy. The etiology of MCD has not been clarified to date. The coexistence of MCD with chronic myelomonocytic leukemia (CMML) has been rarely reported. Although the pathogenesis remains unclear, this association probably reflects an incidental and fortuitous finding rather than the alteration of a common pluripotent stem cell precursor. Herein, we report on one case of MCD coexisting with CMML and elucidate the underlying mechanism of pathology in some aspects.
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Marco Martin C, Méndez Gallart R, Aliste Santos C, Fraga Rodriguez MF, Bautista Casasnovas A. Castleman's Disease in the Paediatric Neck. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018. [DOI: 10.1016/j.otoeng.2017.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sitenga J, Aird G, Ahmed A, Silberstein PT. Impact of siltuximab on patient-related outcomes in multicentric Castleman's disease. PATIENT-RELATED OUTCOME MEASURES 2018; 9:35-41. [PMID: 29391839 PMCID: PMC5769562 DOI: 10.2147/prom.s140011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Multicentric Castleman’s disease (MCD) is a rare, widespread lymphoproliferative disorder and a life-threatening disease involving hyperactivity of the immune system, excessive proinflammatory cytokine release, immune cell proliferation, and organ system dysfunction. Interleukin-6 (IL-6) is a cytokine that plays a key role in the pathogenesis of MCD, as it is involved in the synthesis of acute-phase reactants and aids in the induction of B-cell proliferation. Siltuximab is an anti-IL-6 chimeric monoclonal antibody that acts as a novel treatment modality to bind to IL-6 with high affinity, thus neutralizing the cytokine bioactivity and inhibiting B-cell proliferation. Clinical trials with siltuximab have shown early clinical promise for patients with MCD for many years, leading to recent US Food and Drug Administration approval as a novel agent for the treatment of MCD. Here, a systematic review was conducted to include 171 cases of MCD patients treated with siltuximab. While traditional treatment methods were able to achieve a 5-year survival rate of only 55%–77%, results of siltuximab treatment demonstrated 5-year survival rates of nearly 96.4% (only 2 deaths reported out of 55 patients with follow-up data). Ultimately, the results from multiple clinical trials have demonstrated that siltuximab is extremely efficacious in alleviating disease symptoms (fatigue, pain, and lymphadenopathy) while simultaneously achieving disease remission, thus extending progression-free survival for years longer than the average 5-year survival rates for MCD.
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Affiliation(s)
- Jenna Sitenga
- Division of Education, Creighton University School of Medicine, Omaha, NE, USA
| | - Gregory Aird
- Division of Education, Creighton University School of Medicine, Omaha, NE, USA
| | - Aabra Ahmed
- Division of Education, Creighton University School of Medicine, Omaha, NE, USA
| | - Peter T Silberstein
- Division of Hematology/Oncology, Creighton University School of Medicine, Omaha, NE, USA
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Marco Martin C, Méndez Gallart R, Aliste Santos C, Fraga Rodriguez MF, Bautista Casasnovas A. Castleman's disease in the paediatric neck. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 69:117-119. [PMID: 28527492 DOI: 10.1016/j.otorri.2017.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/01/2017] [Indexed: 01/06/2023]
Affiliation(s)
- Cristina Marco Martin
- Servicio de Cirugía Pediátrica, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España.
| | - Roberto Méndez Gallart
- Servicio de Cirugía Pediátrica, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | - Carlos Aliste Santos
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | - Máximo Francisco Fraga Rodriguez
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | - Adolfo Bautista Casasnovas
- Servicio de Cirugía Pediátrica, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España
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Yu G, Cao F, Gong H, Liu P, Sun G, Zhang W. Embolization of blood-supply artery followed by surgery for treatment of mesorectal Castleman's disease: case report and literature review. Gastroenterol Rep (Oxf) 2017; 7:141-145. [PMID: 28057712 PMCID: PMC6454847 DOI: 10.1093/gastro/gow040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/17/2016] [Accepted: 10/26/2016] [Indexed: 12/20/2022] Open
Abstract
A 23-year-old male patient was diagnosed as having a hypervascular pelvic mass by ultrasonography and magnetic resonance examination. A pathology puncture showed vitreous vascular Castleman’s disease. Because of concerns about tumor blood supply, embolization under digital subtraction angiography (DSA) was performed on the artery of the pelvic tumor before resection of the mass and surrounding rectum. Castleman’s disease of pelvic lymph node (mixed type, mainly hyaline vascular type) was confirmed pathologically from postoperative biopsy. Embolization of the blood-supply artery of a hypervascular mass should be considered before surgery is performed.
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Affiliation(s)
- Guanyu Yu
- Department of Colorectal Surgery, Changhai Hospital, Shanghai, China
| | - Fuao Cao
- Department of Colorectal Surgery, Changhai Hospital, Shanghai, China
| | - Haifeng Gong
- Department of Colorectal Surgery, Changhai Hospital, Shanghai, China
| | - Peng Liu
- Department of Colorectal Surgery, Changhai Hospital, Shanghai, China
| | - Ge Sun
- Department of Colorectal Surgery, Changhai Hospital, Shanghai, China
| | - Wei Zhang
- Department of Colorectal Surgery, Changhai Hospital, Shanghai, China
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