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Luo JM, Li S, Huang H, Cao J, Xu K, Bi YL, Feng RE, Huang C, Qin YZ, Xu ZJ, Xiao Y. Clinical spectrum of intrathoracic Castleman disease: a retrospective analysis of 48 cases in a single Chinese hospital. BMC Pulm Med 2015; 15:34. [PMID: 25886851 PMCID: PMC4404013 DOI: 10.1186/s12890-015-0019-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 03/06/2015] [Indexed: 12/11/2022] Open
Abstract
Background Thorax is the common place to develop Castleman disease (CD), but there is no systemic clinical analysis for intrathoracic CD. Methods We conducted a retrospective analysis of 48 intrathoracic CD patients with definite pathological diagnosis who were hospitalized between 1992 and 2012 in a Chinese tertiary referral hospital. Results The study included 16 cases with unicentric CD (UCD) and 32 cases with multicentric CD (MCD). UCD were younger than MCD (30.5y vs 41.6ys, P < 0.05). MCD were more symptomatic (50% vs 96.9%, P < 0.001) and sicker than UCD, including more fever, hepatomegaly and/or splenomegaly and hypoalbuminemia. All of UCD showed solitary mass in various sites and two of them were complicated by small pleural effusion. In the MCD group, their chest CT showed obvious lymphadenopathy in the hilum and/or mediastinum (100%), diffuse parenchymal lung shadows (43.75%), pleural effusion (40.6%), mass in the mediastinum (6.25%) or hilum (3.12%) and bronchiolitis obliterans (BO) (3.12%). Besides LIP-like images, multiple nodules of different size and sites, patchy, ground-glass opacities and consolidation were showed in their chest CT. Surgery were arranged for all UCD for diagnosis and treatment and all were alive. In MCD group, superficial lymph nodes biopsies (21 cases), surgery biopsy (9 cases) and CT-guided percutaneous lung biopsy (2 cases) were performed. Hyaline vascular (HV) variant were more common in the UCD group (75% vs 37.5%, P < 0.05). In MCD group, 28 cases were prescribed with chemotherapy, one refused to receive therapy and the rest three were arranged for regular follow-up. Among MCD, 18 cases was improved, 7 cases was stable, 4 cases lost follow-up and 3 cases died. Conclusions Intrathoracic MCD was more common than UCD in our hospital. MCD was older, more symptomic and sicker than UCD. HV variant were more common in UCD. All of UCD showed mass in various intrathoracic locations and surgery resection was performed for all and all were alive. Mass, pleural effusion, BO and diffuse pulmonary shadows, including LIP-like images, multiple nodules of different size and sites, patchy, GGO and consolidations were showed in our MCD. Most of MCD cases were arranged with chemotherapy and their prognosis were worse than UCD’s.
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Affiliation(s)
- Jin Mei Luo
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
| | - Shan Li
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
| | - Hui Huang
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
| | - Jian Cao
- Radiological Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
| | - Kai Xu
- Radiological Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
| | - Ya Lan Bi
- Pathological Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
| | - Rui E Feng
- Pathological Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
| | - Cheng Huang
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
| | - Ying Zhi Qin
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
| | - Zuo Jun Xu
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
| | - Yi Xiao
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.
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Carrillo J, Restrepo CS, Rosado de Christenson M, Ojeda Leon P, Lucia Rivera A, Koss MN. Lymphoproliferative lung disorders: a radiologic-pathologic overview. Part I: Reactive disorders. Semin Ultrasound CT MR 2014; 34:525-34. [PMID: 24332204 DOI: 10.1053/j.sult.2013.05.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Lymphoid tissue is a normal component of the lung and manifests as intrapulmonary lymph nodes, bronchus-associated lymphoid tissue (BALT), peripheral lymphocytic aggregates, solitary lymphocytes, and phagocytic cells. Pulmonary lymphoid lesions are thought to develop as a consequence of anomalous stimulation and response of the bronchus-associated lymphoid tissue and manifests as a spectrum of lymphoproliferative disorders that may be reactive or neoplastic. Reactive disorders are polyclonal abnormalities and include nodular lymphoid hyperplasia, lymphocytic interstitial pneumonia, follicular bronchiolitis, angiofollicular hyperplasia, and enlarged intrapulmonary lymph nodes. Affected patients are often asymptomatic. Imaging findings include focal nodules, diffuse bilateral centrilobular nodules, and hilar or mediastinal masses.
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Affiliation(s)
- Jorge Carrillo
- Department of Radiology, Universidad Nacional de Colombia, Bogota, DC
| | - Carlos S Restrepo
- Department of Radiology, The University of Texas Health Science Center at San Antonio, San Antonio, TX.
| | | | | | - Aura Lucia Rivera
- Department of Radiology, Hospital Universiatario Mayor Mederi, Bogota, DC
| | - Micheal N Koss
- Department of Pathology, University of Southern California, Los Angeles, CA
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Castleman's Disease Mimicking Carotid Body Tumor. ACTA MEDICA MARTINIANA 2012. [DOI: 10.2478/v10201-011-0036-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Castleman's Disease Mimicking Carotid Body TumorThe authors present a case of 41-year-old patient with unicentric type of Castleman's disease in the neck imitating carotid glomus tumor. This rare condition can affect any lymph-node in the body and neck localization occurs only in 14% of cases. The case when Castleman's disease simulating chemodectoma have not been described yet in the literature. The authors give details on the course of the disease, its diagnosis and treatment and the discussion focuses on the reasons why the auxiliary imaging methods have led to the clinical diagnosis of carotid glomus tumor, and why the treatment was chosen.
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