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Kardouni Khoozestani N, Niknami M, Ghanbarzadeh K, Ranji P. Castleman's Disease Intra Parotid, a Case Report and Literature Review. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2021; 22:219-224. [PMID: 34514071 PMCID: PMC8417542 DOI: 10.30476/dentjods.2020.85683.1144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/07/2020] [Accepted: 08/05/2020] [Indexed: 11/19/2022]
Abstract
Castleman’s disease (CD), otherwise known as angiofollicular lymph node hyperplasia, is a rare, poorly understood disorder, which often occurs in a mediastinum. Involvement of parotid
gland is a considerably infrequent event. We present a 15-year-old boy patient with a swelling in the left parotid gland that has been diagnosed with CD. The clinical features,
radiographic findings, and treatment plan are discussed. Furthermore, a thorough literature review demonstrated 57 published cases of CD in salivary gland with their summarized features.
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Affiliation(s)
- Neda Kardouni Khoozestani
- Dept. of Oral and Maxillofacial Pathology, School of Dentistry and Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Niknami
- Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Koroush Ghanbarzadeh
- Dept. of Plastic Surgery, Cancer Institute, Tehran University of Medical Science, Tehran, Iran
| | - Paniz Ranji
- Resident, Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Xiao-dong L, Qiu-xu W, Wei-xian L. Castleman Disease of the Parotid Gland: A Case Report. J Oral Maxillofac Surg 2020; 78:400.e1-400.e6. [DOI: 10.1016/j.joms.2019.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/05/2019] [Accepted: 11/12/2019] [Indexed: 12/23/2022]
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He X, Wang Q, Wu Y, Hu J, Wang D, Qi B, Zhang W, Wang Y, Cheng J. Comprehensive analysis of 225 Castleman's diseases in the oral maxillofacial and neck region: a rare disease revisited. Clin Oral Investig 2017; 22:1285-1295. [PMID: 28980074 DOI: 10.1007/s00784-017-2232-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 09/28/2017] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of the present study was to comprehensively summarize the epidemiological, clinicopathological characteristics, treatments as well as prognosis of Castleman's disease (CD) identified in the oral maxillofacial and neck region. MATERIALS AND METHODS Patients with CD in the oral maxillofacial and neck were retrieved from disease registry at our institution from Jan. 1990 to Dec. 2015. Systematic reviews from both English and Chinese literature were performed to collect the detailed information about the oral maxillofacial and neck CD. The epidemiological, clinicopathological data and treatment outcomes were further statistically analyzed. RESULTS Four patients with the oral maxillofacial and neck CD were identified and histologically confirmed as hyaline-vascular type. They underwent surgical excision without recurrence during the follow-up. Systematic literature reviews identified 221 cases from 123 eligible articles which satisfied the inclusion criteria. In 225 patients, most patients were diagnosed as unicentric (207) or hyaline-vascular type (205) of CD and identified in the neck, and treated by surgical resection with good prognosis. In contrast, the minority of patients was multicentric or plasma-cell/mixed type and treated by chemotherapy with inferior outcomes. Kaplan-Meir analyses revealed that both clinical and pathological types were significantly associated with patients' overall survival. CONCLUSIONS Although rare, most cases of the oral maxillofacial neck CD are found in adults and classified as unicentric and hyaline-vascular type of CD. Complete surgical excision is preferred with favorable prognosis for unicentric disease, whereas chemotherapy is usually exploited for multicentric disease with inferior outcomes. CLINICAL RELEVANCE These data provide comprehensive information about the epidemiology, clinicopathological features, treatments, and outcomes of the oral maxillofacial and neck CD.
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Affiliation(s)
- Xiaotong He
- Jiangsu Key Institute of Stomatology, Nanjing Medical University, 136, Hanzhong Road, Nanjing, 210029, People's Republic of China
| | - Qiong Wang
- Jiangsu Key Institute of Stomatology, Nanjing Medical University, 136, Hanzhong Road, Nanjing, 210029, People's Republic of China
| | - Yaping Wu
- Department of Oral and Maxillofacial Surgery, Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Jiaan Hu
- Department of Oral and Maxillofacial Surgery, Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Dongmiao Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Bin Qi
- Department of Oral Pathology, Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Wei Zhang
- Department of Oral Pathology, Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Yanling Wang
- Jiangsu Key Institute of Stomatology, Nanjing Medical University, 136, Hanzhong Road, Nanjing, 210029, People's Republic of China
| | - Jie Cheng
- Jiangsu Key Institute of Stomatology, Nanjing Medical University, 136, Hanzhong Road, Nanjing, 210029, People's Republic of China. .,Department of Oral and Maxillofacial Surgery, Nanjing Medical University, Nanjing, 210029, People's Republic of China.
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Castleman's Disease Presenting as a Parotid Mass in the Pediatric Population: A Report of 2 Cases. Case Rep Otolaryngol 2015; 2015:691701. [PMID: 26509092 PMCID: PMC4609787 DOI: 10.1155/2015/691701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 09/27/2015] [Indexed: 12/27/2022] Open
Abstract
Introduction. Angiofollicular lymph node hyperplasia (Castleman's disease) is a nonmalignant lymphoproliferative disorder that generally involves the lymph nodes of young adults, most commonly in the mediastinum. Rarely, Castleman's disease may present in the parotid gland. The disease can be further classified into unicentric or multicentric forms, with considerable differences in presentation, treatment, and prognosis. Case(s). We present cases of two pediatric patients, aged 7 and 11, who both presented with a slow-growing, painless parotid mass. In each case, the mass was excised via a superficial parotidectomy and the diagnosis made postoperatively upon further pathologic examination. At 6 months of follow-up, both had fully intact facial nerve function and no evidence of recurrence. Discussion. Castleman's disease presents a diagnostic challenge in the head and neck region, as radiographic characteristics and fine needle aspiration results are often inconclusive. Definitive diagnosis requires surgical excision for pathologic examination. The unicentric form generally presents as a painless mass and can be successfully treated with complete excision. The multicentric form is associated with constitutional symptoms and its treatment remains controversial. Conclusion. Although rare, clinicians should be aware of both forms of Castleman's disease when creating a differential diagnosis for parotid masses.
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Multicentric Castleman's Disease in a Hepatitis C-Positive Intravenous Drug User: A Case Report. Case Rep Med 2011; 2011:567840. [PMID: 21577263 PMCID: PMC3090653 DOI: 10.1155/2011/567840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Revised: 02/02/2011] [Accepted: 02/14/2011] [Indexed: 11/30/2022] Open
Abstract
Introduction. We report a rare presentation of Castleman's disease in a hepatitis C-positive patient and present a short review of treatments described in other similar case reports and studies. Case Presentation. A 46-year-old male with untreated hepatitis C and a 16-year history of intravenous drug use presented with pleuritic chest pain and bony pain in the knee, hip, and lower back, on a background of unexplained weight loss of 40 kilograms, fevers, night sweats, and repeated infections over the last two years. Examination discovered tender hepatomegaly, a warm right knee effusion, and painless lymphadenopathy. The patient was reactive to Epstein Barr virus and cytomegalovirus; however, HIV and HHV-8 viral testing was negative. Osteomyelitis of vertebrae T8–T11 and septic arthritis of the knee were found on investigation. A lymph node biopsy revealed histology suggestive of plasmacytic Castleman's disease. The patient is to commence rituximab treatment.
Conclusion. Castleman's disease continues to present in novel ways, which may lead to difficulties in clinicopathologic diagnosis. A growing body of evidence suggests larger studies are required to determine the best treatment for multicentric Castleman's disease, particularly in patients with a concomitant disease, including hepatitis C.
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Gürbüzler L, Ceylan A, Yilmaz M, Vural Ç. Castleman's Disease of the Parotid Gland: A Case Report. Kaohsiung J Med Sci 2010; 26:444-7. [DOI: 10.1016/s1607-551x(10)70071-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Accepted: 01/19/2010] [Indexed: 10/19/2022] Open
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Zhong LP, Wang LZ, Ji T, Hu YH, Hu YJ, Ye WM, Li J, Sun J, Zhu HG, Li J, Zhang CP. Clinical analysis of Castleman disease (hyaline vascular type) in parotid and neck region. ACTA ACUST UNITED AC 2009; 109:432-40. [PMID: 19969478 DOI: 10.1016/j.tripleo.2009.09.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Revised: 09/17/2009] [Accepted: 09/18/2009] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The aim of this study was to analyze a single institution's experience in clinical diagnosis, treatment, and prognosis of Castleman disease (hyaline vascular type) in the parotid and neck region. STUDY DESIGN From 2004 to 2008, a total of 10 consecutive patients with Castleman disease (hyaline vascular type) in the parotid and neck region underwent surgery were included in this retrospective study. The preoperative examinations, clinical diagnosis, surgical treatment, and prognosis were recorded and analyzed. RESULTS Of the 10 patients, 4 were males and 6 female; their age ranged from 13 to 54 years with a mean of 26.6 years. The lesion occurred in the parotid region in 3 patients, in the neck region in 5 patients, and in both the parotid and neck regions in 2 patients. Their course of disease ranged from 3 months to 48 months with a mean of 12.5 months; 70% of the patients (7 out of 10) had a course of disease of <12 months. The patients always had no obvious complaint, and the laboratory examinations were almost within the normal limits. Magnetic resonance imaging/angiography were valuable on clinical diagnosis and differential diagnosis. All patients underwent surgical removal of the masses completely. During the follow-up period, which ranged from 9 months to 60 months with a mean of 38.9 months, no recurrence of the lesion occurred, and the quality of life of each patient was good. CONCLUSIONS Castleman disease (hyaline vascular type) in the parotid and neck region is rare, with clinical manifestation and physical examination the same as benign lesions. There is no specific indication in the laboratory tests and imaging examinations; however, magnetic resonance imaging/angiography has potential value on clinical diagnosis and differential diagnosis. Surgical resection is the choice of treatment with good prognosis.
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Affiliation(s)
- Lai-ping Zhong
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, Shanghai, China
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Caselli E, Padovani D, Di Carlo R, Grandi E, Galvan M, Cassai E, Pastore A. Parotid localized Castleman’s disease and HHV-8 infection: a case report. Eur Arch Otorhinolaryngol 2007; 265:377-80. [PMID: 17899145 DOI: 10.1007/s00405-007-0453-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2006] [Accepted: 09/10/2007] [Indexed: 10/22/2022]
Abstract
Castleman's disease (CD) is an unusual massive proliferation of lymphoid tissue distinct in two clinical forms, localized and multicentric. The multicentric form has been related to human herpesvirus 8 (HHV-8), especially in HIV-infected patients, whereas the localized form of CD is still unrelated to viral pathogens. We report a case of a HIV-negative 16-year-old male referred to our hospital with a 12-month history of a painless swelling in his right parotid region. A parotidectomy was performed, and histological analysis evidenced a localized CD. The search for HHV-8 revealed an active virus infection. The patient was commenced on corticosteroid therapy and a follow-up was performed every 6 months. The patient was commenced on corticosteroid therapy and there has been no recurrence after 24 months. The authors report a case of localized parotid CD in a patient with evidence of an active HHV-8 infection. The results of this study does for the first time suggest an association between HHV-8 and localized CD in HIV-negative subjects.
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Affiliation(s)
- Elisabetta Caselli
- Section of Microbiology, Department of Experimental and Diagnostic Medicine, University of Ferrara, Ferrara, Italy
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Abstract
CASE REPORT A 25-year-old patient with fever, dysphagia, and reduced general condition was referred to our department by his dentist after 1 week of antibiotic therapy. He presented with a painful palpable mass in the right lower jaw that had developed 2 weeks before. The orthopantomogram showed a caries and periapical lesion at the right lower wisdom tooth. During extraction of the tooth and putative intra- and extraoral abscess incision, no pus could be drained and the mass persisted. CT scans then revealed lobulated soft tissue masses on both sides of the neck with the main focus on the right side. In an additional operation with excision of the mass, Castleman's disease of the hyaline vascular type was diagnosed. HISTOPATHOLOGIC FINDINGS Staging could not detect further pathological findings and the patient's postoperative general condition improved continuously. The histological features of the hayline vascular type of Castleman's disease were characterized by multiple germinal centers surrounded by circumferentially arranged layers of small lymphocytes interconnected by a prominent vascular stroma with occasional plasma cells ("onion skin"). CONCLUSION Castleman's disease is a rare and yet poorly understood disease, characterized by inhomogeneous growth of lymphoid tissue. Mostly benign it remains a diagnostic challenge before histological investigation. In unclear submandibular swellings and neck lumps assumed to be an abscess, this rare differential diagnosis must be considered. Facing recurrence and potential for malignancy, follow-up of the patients over several years is necessary.
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Affiliation(s)
- F Hölzle
- Klinik für Mund-, Kiefer- und Plastische Gesichtschirurgie der Ruhr-Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer, 44892 Bochum.
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Castleman disease of the parotid gland: MR imaging findings with pathologic correlation. ACTA ACUST UNITED AC 2003. [DOI: 10.1016/s1571-4675(03)00028-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Maruyama S, Hao N, Cheng J, Horino K, Ohnishi M, Fukushi M, Fujii M, Saku T. Castleman's disease of the buccal mucosa: report of a case and review of the literature of head and neck cases. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 93:305-10. [PMID: 11925540 DOI: 10.1067/moe.2002.120026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A case of Castleman's disease occurring in the buccal mucosa is described. An 84-year-old woman noticed that a mass in the left buccal mucosa that had been present for half a year. Computed tomography revealed a well-demarcated submucosal tumor, measuring 4.0 x 3.0 x 2.0 cm. The patient received no treatment at this time, and continued growth of the mass was observed. After incisional biopsy, the lesion was surgically removed. Histologically, the tumor consisted of an enlarged lymph node with conspicuous lymph follicles, in which vascular channels and deposits of eosinophilic material were noted. Laboratory examination showed an increase of serum antibody level of cytomegalovirus but of no other viruses. The patient was followed up for 1(1/2) years, with no clinical evidence of recurrence. This is the first report of Castleman's disease presenting in an oral site.
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Affiliation(s)
- Satoshi Maruyama
- Department of Pathology, Faculty of Dentistry, Niigata University, Japan
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Sanchez-Cuellar A, de Pedro M, Martin-Granizo R, Berguer A. Castleman disease (giant lymph node hyperplasia) in the maxillofacial region: a report of 3 cases. J Oral Maxillofac Surg 2001; 59:228-31. [PMID: 11213998 DOI: 10.1053/joms.2001.20507] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A Sanchez-Cuellar
- Department of Oral and Maxillofacial Surgery, Hospital Clínico, San Carlos, Madrid, Spain
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Affiliation(s)
- O Nahlieli
- Oral and Maxillofacial Surgery Department, Barzilai Medical Center, Ashkelon, Israel.
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