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Lee YC, Lu CW, Hsieh MS, Hsu HH. Clinicopathological characteristics of unicentric Castleman disease: A single-center experience of 12 patients. J Formos Med Assoc 2024:S0929-6646(24)00475-3. [PMID: 39362821 DOI: 10.1016/j.jfma.2024.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 09/16/2024] [Accepted: 09/27/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Castleman disease (CD) is an uncommon lymphoproliferative disorder with distinct pathological characteristics. Unicentric Castleman disease (UCD) presents as a single lymph node enlargement, often without significant symptoms. Complete surgical resection is the standard treatment for UCD. This study aimed to explore the clinicopathological features of UCD in a Taiwanese population. METHODS We retrospectively identified 12 patients with UCD who had undergone surgical treatment between January 1, 2006 and June 30, 2022 at the National Taiwan University Hospital. Clinical and radiological findings were retrieved from medical records. All available pathological slides were reviewed. RESULTS The patients' mean age was 38.1 years (range, 17 to 69); five (41.7%) were male, and seven (58.3%) were female. Nearly all cases of UCD were in the mediastinum, except for one case in the neck. Most patients were asymptomatic and without abnormal laboratory test results. Computed tomography revealed well-defined tumor borders, contrast enhancement, and occasional calcification. Ten patients underwent en bloc tumor resection, while the remaining two underwent partial resection. Among them, seven (58.3%) underwent video-assisted thoracoscopic surgery (VATS), and four (33.3%) underwent thoracotomy. The mean follow-up duration was 92 months. The patients who underwent total resection had no recurrence. CONCLUSION Detailed clinicopathological information on UCD in the Taiwanese population is present in our article. Both complete and partial surgery are effective for treatment. VATS may be preferred over thoracotomy due to less operative time and bleeding.
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Affiliation(s)
- Yi-Chieh Lee
- National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Chao-Wen Lu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Min-Shu Hsieh
- Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Pathology, National Taiwan University Cancer Center, Taipei, Taiwan.
| | - Hsao-Hsun Hsu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
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Gao H, Li W, Zou B, Liu S, Miao C. Clinical features and outcomes of retroperitoneal unicentric Castleman disease resected as sarcomas: insights from a high-volume sarcoma center. Front Surg 2024; 11:1371968. [PMID: 39301171 PMCID: PMC11410775 DOI: 10.3389/fsurg.2024.1371968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 08/27/2024] [Indexed: 09/22/2024] Open
Abstract
Background Castleman disease (CD) is a rare lymphoproliferative disorder that can occur anywhere along the lymphatic pathway. Retroperitoneal unicentric Castleman disease (UCD) is an extremely rare manifestation. This study aims to explore the clinical features and surgical treatment of retroperitoneal UCD. Methods We retrospectively reviewed patients who underwent retroperitoneal tumor surgery and were diagnosed with CD based on postoperative pathology before December 31, 2022. Data from these patients were collected and analyzed. Results A total of 15 patients were included in the final analysis. All patients underwent radical resection under general anesthesia. Two out of 15 patients (13.3%) experienced serious complications but recovered well. There were no perioperative deaths. The median follow-up time was 78.5 months (range: 18-107.5 months), and no deaths or recurrences occurred during this period. Conclusions Surgical treatment for retroperitoneal UCD is safe. Patients with retroperitoneal UCD can achieve long-time survival through complete resection.
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Affiliation(s)
- Haicheng Gao
- Department of Retroperitoneal Tumor Surgery, Peking University International Hospital, Beijing, China
| | - Wenjie Li
- Department of Retroperitoneal Tumor Surgery, Peking University International Hospital, Beijing, China
| | - Boyuan Zou
- Department of Retroperitoneal Tumor Surgery, Peking University International Hospital, Beijing, China
| | - Shibo Liu
- Department of Retroperitoneal Tumor Surgery, Peking University International Hospital, Beijing, China
| | - Chengli Miao
- Department of Retroperitoneal Tumor Surgery, Peking University International Hospital, Beijing, China
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Deng Q, Wang Y, Liu T, Li Z, Liu BY. A case of adrenal Castleman disease combined with liver cirrhosis and splenomegaly. Urol Case Rep 2024; 56:102810. [PMID: 39157017 PMCID: PMC11327473 DOI: 10.1016/j.eucr.2024.102810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/21/2024] [Accepted: 07/21/2024] [Indexed: 08/20/2024] Open
Abstract
To describe a rare case of left adrenal Castleman disease (CD), splenomegaly, and cirrhosis. An examination revealed a left adrenal mass for more than three months, the patient, 44, was well-prepared for surgery after her left adrenal tumor was removed laparoscopically using a retroperitoneal approach, her postoperative pathology suggested that she had Castleman disease of the adrenal glands, and there had been no metastasis or recurrence during the six-month follow-up period. We have evaluated linked literature reports in this article, reporting relevant clinical knowledge regarding the disease and synthesizing previous research, in an effort to increase our understanding of it.
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Affiliation(s)
- Qilang Deng
- Second Clinical Medical College of Binzhou Medical College, China
| | - Yinglei Wang
- Department of Urology, Yantai Affiliated Hospital, Binzhou Medical College, Binzhou, China
| | - Tong Liu
- Department of Pathology, Yantai Affiliated Hospital, Binzhou Medical College, Binzhou, China
| | - Zhigang Li
- Second Clinical Medical College of Binzhou Medical College, China
| | - Bo-You Liu
- Second Clinical Medical College of Binzhou Medical College, China
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Wang WX, Peng LL, Du HH, Liu JJ. A case of retroperitoneal hyaline-vascular Castleman disease presenting initially with anemia. Asian J Surg 2024:S1015-9584(24)01767-6. [PMID: 39191581 DOI: 10.1016/j.asjsur.2024.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 08/01/2024] [Indexed: 08/29/2024] Open
Affiliation(s)
- Wen-Xu Wang
- Department of Graduate School, Hebei North University, Zhangjiakou, Hebei, 075000, China; Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, 050000, China
| | - Li-Li Peng
- Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei, 050000, China
| | - Hong-Hu Du
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, 050000, China; Department of Graduate School, Hebei Medical University, Shijiazhuang, Hebei, 050000, China
| | - Jun-Jiang Liu
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, 050000, China.
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5
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Zhang MY, Li J, Wang YN, Tian Z, Zhang L. Unicentric Castleman's disease presenting as amyloid A cardiac amyloidosis: a case report. Ann Hematol 2024; 103:367-368. [PMID: 37882865 DOI: 10.1007/s00277-023-05493-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/03/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Miao-Yan Zhang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Number 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Jian Li
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Number 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Yi-Ning Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Number 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Zhuang Tian
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Number 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Lu Zhang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Number 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China.
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6
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Zhu Q, Wang S. Castleman disease of plasma cell type accompanied with bronchiolitis obliterans: a case report and review of the literature. J Med Case Rep 2023; 17:539. [PMID: 38082371 PMCID: PMC10714532 DOI: 10.1186/s13256-023-04285-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Castleman disease, also known as giant lymph node hyperplasia or angiofollicular lymph node hyperplasia, is a highly heterogeneous clinicopathological entity that belongs to the family lymphoproliferative disorders. Castleman disease accompanied by bronchiolitis obliterans is uncommon and often poses a great diagnostic challenge, which is easily confused with respiratory diseases and impeding the correct diagnosis and treatment. The main aim in presenting such rare case studies is to raise awareness and expand the diagnostic horizon of clinicians for appropriate management. CASE PRESENTATION Here, we present a 69-year-old Chinese male who was admitted to our hospital due to right chest pain for 6 months, accompanied by cough, expectoration, and fever. Laboratory examinations revealed elevated immunoglobulin G and C-reactive protein, and normal serum levels of tumor markers and interleukin-6. Computed tomography scan detected diffuse bronchial wall thickening and patchy area of air trapping consistent with small airway disease. Pulmonary function test showed mild small airway obstructive ventilation dysfunction and moderate decrease in diffusion capacity. The pathological result of the right axillary lymph node was consistent with the plasma cell type Castleman disease. According to the above examinations, the patient was finally diagnosed with the plasma cell type Castleman disease accompanied with bronchiolitis obliterans. He received immunosuppressive medication after surgery and has been followed up for 11 months. Now the patient is currently in stable condition without recurrence. CONCLUSION Castleman disease is a rare lymphoproliferative disorder with a variety of symptoms. At present, the treatment of Castleman disease accompanied with bronchiolitis obliterans is mostly based on experiences or previous case reports, and there is no standard treatment. Here, we report an uncommon case of Castleman disease accompanied with bronchiolitis obliterans in which the patient received immunosuppressive medication after surgery and has been followed up for 11 months without experiencing a recurrence, which may deepen and extend our understanding of this disease.
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Affiliation(s)
- Qingyuan Zhu
- Department of Respiratory Diseases, Quzhou TCM Hospital at the Junction of Four Provinces Affiliated to Zhejiang Chinese Medical University, Quzhou, 324002, Zhejiang Province, China
| | - Shuiyou Wang
- Department of Respiratory Diseases, Quzhou TCM Hospital at the Junction of Four Provinces Affiliated to Zhejiang Chinese Medical University, Quzhou, 324002, Zhejiang Province, China.
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Bustamante MS, Shyamsundar S, Coren FR, Bagg A, Srkalovic G, Alapat D, van Rhee F, Lim MS, Lechowicz MJ, Brandstadter JD, Pierson SK, Fajgenbaum DC. Ongoing symptoms following complete surgical excision in unicentric Castleman disease. Am J Hematol 2023; 98:E334-E337. [PMID: 37635628 PMCID: PMC10998479 DOI: 10.1002/ajh.27065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/18/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023]
Affiliation(s)
- Mateo S. Bustamante
- Center for Cytokine Storm Treatment & Laboratory, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Saishravan Shyamsundar
- Center for Cytokine Storm Treatment & Laboratory, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Freda R. Coren
- Department of Medical Education, Dell Medical School, Austin, TX, 78712, USA
| | - Adam Bagg
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Gordan Srkalovic
- Sparrow Herbert-Herman Cancer Center, Michigan State University College of Human Medicine, Lansing, MI, 48912, USA
| | - Daisy Alapat
- Department of Pathology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Frits van Rhee
- Myeloma Center, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Megan S. Lim
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, 10065, USA
| | - Mary Jo Lechowicz
- Department of Hematology and Medical Oncology, Emory University School of Medicine and Winship Cancer Institute, Atlanta, GA, 30322, USA
| | - Joshua D. Brandstadter
- Division of Hematology/Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Sheila K. Pierson
- Center for Cytokine Storm Treatment & Laboratory, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - David C. Fajgenbaum
- Center for Cytokine Storm Treatment & Laboratory, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
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Chen T, Feng C, Zhang X, Zhou J. TAFRO syndrome: A disease that known is half cured. Hematol Oncol 2023; 41:310-322. [PMID: 36148768 DOI: 10.1002/hon.3075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/22/2022] [Accepted: 09/17/2022] [Indexed: 11/10/2022]
Abstract
Thrombocytopenia, anasarca, fever, reticulin fibrosis/renal failure, and organomegaly (TAFRO) syndrome is rare in clinical practice. It is a systemic inflammatory disease caused by a cytokine storm. Its clinical manifestations include thrombocytopenia, systemic edema, fever, bone marrow fibrosis, renal insufficiency, and organ enlargement. The high mortality rate of TAFRO syndrome is due to the difficulty of acquiring biopsy samples for diagnosis and the rapid disease progression. This disease is poorly understood by clinicians. Early detection, accurate diagnosis, and timely treatment play key roles in prolonging the survival of the patients. This review summarizes the latest progress in the pathogenesis, diagnostic criteria, and treatment regimens of TAFRO syndrome, aiming to help clinicians better understand TAFRO syndrome and improve its diagnosis and treatment.
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Affiliation(s)
- Tingting Chen
- Department of Hematology, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
| | - Chun Feng
- Department of Hematology, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
- Department of Hematology, Shenzhen People's Hospital, Shenzhen, Guangdong, China
- The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Xinyou Zhang
- Department of Hematology, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
- Department of Hematology, Shenzhen People's Hospital, Shenzhen, Guangdong, China
- The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Jihao Zhou
- Department of Hematology, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
- Department of Hematology, Shenzhen People's Hospital, Shenzhen, Guangdong, China
- The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
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9
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Zhang L, Dong YJ, Peng HL, Li H, Zhang MZ, Wang HH, Liu QH, Su LP, Zhong LY, Wu WJ, Huang L, Yan XJ, Fan L, Tang WJ, Li ZL, Bi LT, Li Y, Gao GX, Gao L, Liu TB, Wei YQ, Liu Y, Yu L, Zhou H, Sun CY, Qian WB, Zou DH, Zhang HL, Ding KY, Wang XB, Bai O, Huang WR, Chen B, Yang L, Song J, Gao D, Chen T, Luo J, Wang SY, Ma LM, Fajgenbaum DC, Li J. A national, multicenter, retrospective study of Castleman disease in China implementing CDCN criteria. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 34:100720. [PMID: 37283978 PMCID: PMC10240357 DOI: 10.1016/j.lanwpc.2023.100720] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 06/08/2023]
Abstract
Background Castleman disease (CD) is a group of rare and heterogenous lymphoproliferative disorders including unicentric CD (UCD), human herpesvirus-8(HHV-8)-associated multicentric CD (HHV8-MCD), and HHV-8-negative/idiopathic multicentric CD (iMCD). Knowledge of CD mainly comes from case series or retrospective studies, but the inclusion criteria of these studies vary because the Castleman Disease Collaborative Network (CDCN) diagnostic criteria for iMCD and UCD were not available until 2017 and 2020, respectively. Further, these criteria and guidelines have not been systematically evaluated. Methods In this national, multicenter, retrospective study implementing CDCN criteria, we enrolled 1634 CD patients (UCD, n = 903; MCD, n = 731) from 2000 to 2021 at 40 Chinese institutions to depict clinical features, treatment options, and prognostic factors of CD. Findings Among UCD, there were 162 (17.9%) patients with an MCD-like inflammatory state. Among MCD, there were 12 HHV8-MCD patients and 719 HHV-8-negative MCD patients, which included 139 asymptomatic MCD (aMCD) and 580 iMCD meeting clinical criteria. Of 580 iMCD patients, 41 (7.1%) met iMCD-TAFRO criteria, the others were iMCD-NOS. iMCD-NOS were further divided into iMCD-IPL (n = 97) and iMCD-NOS without IPL (n = 442). Among iMCD patients with first-line treatment data, a trend from pulse combination chemotherapy toward continuous treatment was observed. Survival analysis revealed significant differences between subtypes and severe iMCD (HR = 3.747; 95% CI: 2.112-6.649, p < 0.001) had worse outcome. Interpretation This study depicts a broad picture of CD, treatment options and survival information in China and validates the association between the CDCN's definition of severe iMCD and worse outcomes, requiring more intensive treatment. Fundings Beijing Municipal Commission of Science and Technology, CAMS Innovation Fund and National High Level Hospital Clinical Research Funding.
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Affiliation(s)
- Lu Zhang
- Department of Haematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu-jun Dong
- Department of Haematology, Peking University First Hospital, Beijing, China
| | - Hong-ling Peng
- Department of Haematology, Second Xiang-ya Hospital, Central South University, Changsha, China
| | - Hao Li
- Department of Haematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ming-zhi Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui-han Wang
- Department of Haematology, Sheng Jing Hospital of China Medical University, Shenyang, China
| | - Qin-hua Liu
- Department of Haematology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Li-ping Su
- Department of Haematology, Shanxi Province Cancer Hospital, Taiyuan, China
| | - Li-ye Zhong
- Department of Haematology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wen-jun Wu
- Bone Marrow Transplantation Center, The First Affiliated Hospital of Zhejiang Medical College, Zhejiang University, Hangzhou, China
| | - Liang Huang
- Department of Haematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-jing Yan
- Department of Haematology, First Hospital of China Medical University, Shenyang, China
| | - Lei Fan
- Department of Haematology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
| | - Wen-jiao Tang
- Department of Haematology, West China Hospital Sichuan University, Chengdu, China
| | - Zhen-ling Li
- Department of Haematology, China-Japan Friendship Hospital, Beijing, China
| | - Lin-tao Bi
- Department of Haematology and Oncology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yan Li
- Department of Haematology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Guang-xun Gao
- Department of Haematology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Li Gao
- Department of Haematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Ting-bo Liu
- Department of Haematology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yong-qiang Wei
- Department of Haematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yao Liu
- Department of Haematology/Oncology, Chongqing University Cancer Hospital, Chongqing Cancer Hospital, Chongqing, China
| | - Li Yu
- Department of Haematology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hui Zhou
- Department of Lymphoma & Haematology, Hunan Cancer Hospital/The Affiliated Tumor Hospital of Xiangya Medical School, Central South University, Changsha, China
| | - Chun-yan Sun
- Institute of Haematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wen-bin Qian
- Department of Haematology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - De-hui Zou
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Haematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Haematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Hui-lai Zhang
- Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Kai-yang Ding
- Department of Haematology, The First Affiliated Hospital of USTC, Hefei, China
| | - Xiao-bo Wang
- Department of Haematology, The Second Hospital of Dalian Medical University, Dalian, China
| | - Ou Bai
- Department of Haematology, The First Hospital of Jilin University, Changchun, China
| | - Wen-rong Huang
- Department of Haematology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Bing Chen
- Department of Haematology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Lin Yang
- Department of Haematology, Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jia Song
- Department of Haematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Da Gao
- Department of Haematology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Tong Chen
- Department of Haematology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jun Luo
- Department of Haematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Shu-ye Wang
- Department of Haematology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Liang-ming Ma
- Department of Haematology, Shanxi Bethune Hospital, Taiyuan, China
| | - David C. Fajgenbaum
- Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jian Li
- Department of Haematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - China Castleman Disease Network (CCDN)
- Department of Haematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Haematology, Peking University First Hospital, Beijing, China
- Department of Haematology, Second Xiang-ya Hospital, Central South University, Changsha, China
- Department of Haematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Haematology, Sheng Jing Hospital of China Medical University, Shenyang, China
- Department of Haematology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Haematology, Shanxi Province Cancer Hospital, Taiyuan, China
- Department of Haematology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, China
- Bone Marrow Transplantation Center, The First Affiliated Hospital of Zhejiang Medical College, Zhejiang University, Hangzhou, China
- Department of Haematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Haematology, First Hospital of China Medical University, Shenyang, China
- Department of Haematology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
- Department of Haematology, West China Hospital Sichuan University, Chengdu, China
- Department of Haematology, China-Japan Friendship Hospital, Beijing, China
- Department of Haematology and Oncology, China-Japan Union Hospital of Jilin University, Changchun, China
- Department of Haematology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
- Department of Haematology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
- Department of Haematology, Xinqiao Hospital, Army Medical University, Chongqing, China
- Department of Haematology, Fujian Medical University Union Hospital, Fuzhou, China
- Department of Haematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Haematology/Oncology, Chongqing University Cancer Hospital, Chongqing Cancer Hospital, Chongqing, China
- Department of Haematology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Lymphoma & Haematology, Hunan Cancer Hospital/The Affiliated Tumor Hospital of Xiangya Medical School, Central South University, Changsha, China
- Institute of Haematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Haematology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Haematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Haematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Department of Haematology, The First Affiliated Hospital of USTC, Hefei, China
- Department of Haematology, The Second Hospital of Dalian Medical University, Dalian, China
- Department of Haematology, The First Hospital of Jilin University, Changchun, China
- Department of Haematology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- Department of Haematology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Department of Haematology, Second Hospital of Hebei Medical University, Shijiazhuang, China
- Department of Haematology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Haematology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
- Department of Haematology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Haematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Department of Haematology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
- Department of Haematology, Shanxi Bethune Hospital, Taiyuan, China
- Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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10
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Liu J, Feng G. A 41-Year-Old Man With an Abdominal Mass and Hepatomegaly. Gastroenterology 2023; 164:e10-e13. [PMID: 35987445 DOI: 10.1053/j.gastro.2022.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 08/16/2022] [Indexed: 01/31/2023]
Affiliation(s)
- Jianwei Liu
- Department of Gastroenterology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Gege Feng
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
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11
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Viallard JF, Roriz M, Parrens M, Bonnotte B. Diagnostics différentiels de la maladie de Castleman. Rev Med Interne 2022; 43:10S17-10S25. [PMID: 36657939 DOI: 10.1016/s0248-8663(23)00021-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Clinicians are sometimes confronted with the diagnostic difficulties of the idiopathic form of Castleman's Disease (iMCD). As this review reports with demonstrative clinical cases, iMCD can mimic various serious systemic pathologies such as certain autoimmune diseases, Still's disease, POEMS syndrome, and malignant lymphoproliferations, sharing a very similar histology and identical symptoms. To make a diagnosis of iMCD, the clinician must eliminate all the pathologies mentioned above, but he must first think of it and evoke this diagnosis of rare disease before the first symptoms but also know how to evoke this diagnosis again even after several years of evolution of a disease like those mentioned above whose evolution is not favorable. © 2022 Published by Elsevier Masson SAS on behalf of Société nationale française de médecine interne (SNFMI).
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Affiliation(s)
- J F Viallard
- Service de médecine interne et maladies infectieuses, hôpital Haut-Lévêque, CHU de Bordeaux, 5, avenue de Magellan, 33604 Pessac, France.
| | - M Roriz
- Service de médecine interne et maladies infectieuses, hôpital d'Agen, Agen, France
| | - M Parrens
- Service d'anatomopathologie, hôpital Haut-Lévêque, CHU de Bordeaux, 5, avenue de Magellan, 33604 Pessac
| | - B Bonnotte
- Service de médecine interne et immunologie clinique, CHU de Dijon, Dijon, France
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12
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Brandstadter JD, Fajgenbaum DC. How we manage idiopathic multicentric Castleman disease. CLINICAL ADVANCES IN HEMATOLOGY & ONCOLOGY : H&O 2022; 20:564-571. [PMID: 36125948 PMCID: PMC9584165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Joshua D Brandstadter
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - David C Fajgenbaum
- Center for Cytokine Storm Treatment & Laboratory, Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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13
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Transcriptome and unique cytokine microenvironment of Castleman disease. Mod Pathol 2022; 35:451-461. [PMID: 34686774 PMCID: PMC9272352 DOI: 10.1038/s41379-021-00950-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 01/03/2023]
Abstract
Castleman disease (CD) represents a group of rare, heterogeneous and poorly understood disorders that share characteristic histopathological features. Unicentric CD (UCD) typically involves a single enlarged lymph node whereas multicentric CD (MCD) involves multiple lymph node stations. To understand the cellular basis of CD, we undertook a multi-platform analysis using targeted RNA sequencing, RNA in-situ hybridization (ISH), and adaptive immune receptor rearrangements (AIRR) profiling of archived tissue from 26 UCD, 14 MCD, and 31 non-CD reactive controls. UCD showed differential expression and upregulation of follicular dendritic cell markers (CXCL13, clusterin), angiogenesis factors (LPL, DLL4), extracellular matrix remodeling factors (TGFβ, SKIL, LOXL1, IL-1β, ADAM33, CLEC4A), complement components (C3, CR2) and germinal center activation markers (ZDHHC2 and BLK) compared to controls. MCD showed upregulation of IL-6 (IL-6ST, OSMR and LIFR), IL-2, plasma cell differentiation (XBP1), FDC marker (CXCL13, clusterin), fibroblastic reticular cell cytokine (CCL21), angiogenesis factor (VEGF), and mTORC1 pathway genes compared to UCD and controls. ISH studies demonstrated that VEGF was increased in the follicular dendritic cell-predominant atretic follicles and the interfollicular macrophages of MCD compared to UCD and controls. IL-6 expression was higher along interfollicular vasculature-associated cells of MCD. Immune repertoire analysis revealed oligoclonal expansions of T-cell populations in MCD cases (2/6) and UCD cases (1/9) that are consistent with antigen-driven T cell activation. The findings highlight the unique genes, pathways and cell types involved in UCD and MCD. We identify potential novel targets in CD that may be harnessed for therapeutics.
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14
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Carbone A, Borok M, Damania B, Gloghini A, Polizzotto MN, Jayanthan RK, Fajgenbaum DC, Bower M. Castleman disease. Nat Rev Dis Primers 2021; 7:84. [PMID: 34824298 PMCID: PMC9584164 DOI: 10.1038/s41572-021-00317-7] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 01/02/2023]
Abstract
Castleman disease (CD), a heterogeneous group of disorders that share morphological features, is divided into unicentric CD and multicentric CD (MCD) according to the clinical presentation and disease course. Unicentric CD involves a solitary enlarged lymph node and mild symptoms and excision surgery is often curative. MCD includes a form associated with Kaposi sarcoma herpesvirus (KSHV) (also known as human herpesvirus 8) and a KSHV-negative idiopathic form (iMCD). iMCD can present in association with severe syndromes such as TAFRO (thrombocytopenia, ascites, fever, reticulin fibrosis and organomegaly) or POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder and skin changes). KSHV-MCD often occurs in the setting of HIV infection or another cause of immune deficiency. The interplay between KSHV and HIV elevates the risk for the development of KSHV-induced disorders, including KSHV-MCD, KSHV-lymphoproliferation, KSHV inflammatory cytokine syndrome, primary effusion lymphoma and Kaposi sarcoma. A CD diagnosis requires a multidimensional approach, including clinical presentation and imaging, pathological features, and molecular virology. B cell-directed monoclonal antibody therapy is the standard of care in KSHV-MCD, and anti-IL-6 therapy is the recommended first-line therapy and only treatment of iMCD approved by the US FDA and EMA.
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Affiliation(s)
- Antonino Carbone
- Centro di Riferimento Oncologico (CRO), IRCCS, National Cancer Institute, Aviano, Italy.
- S. Maria degli Angeli Hospital, Pordenone, Italy.
| | - Margaret Borok
- Unit of Internal Medicine, University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
| | - Blossom Damania
- Department of Microbiology and Immunology and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Annunziata Gloghini
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Mark N Polizzotto
- Clinical Hub for Interventional Research, John Curtin School of Medical Research, The Australian National University, Canberra, NSW, Australia
| | - Raj K Jayanthan
- Castleman Disease Collaborative Network, Philadelphia, PA, USA
| | - David C Fajgenbaum
- Center for Cytokine Storm Treatment & Laboratory, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Bower
- National Centre for HIV Malignancy, Chelsea & Westminster Hospital, London, UK
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15
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[The consensus of the diagnosis and treatment of Castleman disease in China (2021)]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2021; 42:529-534. [PMID: 34455738 PMCID: PMC8408489 DOI: 10.3760/cma.j.issn.0253-2727.2021.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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