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Wang X, Chen YC, Pan HG, Teng YS. Castleman Disease of the Parapharyngeal Space in a Pediatric Patient: A Case Report. EAR, NOSE & THROAT JOURNAL 2023:1455613231214643. [PMID: 37997614 DOI: 10.1177/01455613231214643] [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: 11/25/2023] Open
Abstract
The Castleman Disease (CD), also recognized as giant lymph node hyperplasia or vascular follicular lymphoid hyperplasia, is an infrequent lymphoproliferative disorder with substantial clinical variability. Parapharyngeal location of this disease is very rare and in pediatric population it is even rarer. This article presents a case of Unicentric CD (hyaline vascular type) in an 8-year-old female, where the disease was localized within the parapharyngeal space. Clinical manifestations were limited to the presence of a local mass, with no other specific symptoms observed. Laboratory assessments revealed no significant abnormalities. She underwent surgery using a cervical-parotid approach and experienced a good postoperative recovery. Histopathological analysis confirmed the diagnosis. This case underscores the need for a comprehensive evaluation and consideration of uncommon etiologies in the assessment of parapharyngeal masses, even in pediatric patients.
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Affiliation(s)
- Xin Wang
- Department of Otorhinolaryngology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
- Department of Otorhinolaryngology, Shenzhen Children's Hospital, China Medical University, Shenzhen, Guangdong, China
| | - Yong-Chao Chen
- Department of Otorhinolaryngology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Hong-Guang Pan
- Department of Otorhinolaryngology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Yi-Shu Teng
- Department of Otorhinolaryngology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
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Gabra A, Awad M, Felemban W, Alawi A. Castleman disease presenting as axillary mass: A case report. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2023. [DOI: 10.1016/j.epsc.2023.102629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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3
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DeMarsh SJ, Kendel NE, Bacha C, Ardoin SP, Kahwash S, Rose MJ. Storming the castle: A case report of multi-system dysregulation in a child with Castleman disease. Clin Case Rep 2022; 10:e05491. [PMID: 35369387 PMCID: PMC8858787 DOI: 10.1002/ccr3.5491] [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: 08/30/2021] [Revised: 01/20/2022] [Accepted: 02/06/2022] [Indexed: 11/09/2022] Open
Abstract
Castleman disease is a non-clonal, lymphoproliferative disorder rarely seen in children. Presented is a 12-year-old male with progressive abdominal pain, vomiting, and fever. Diagnostic testing revealed multi-organ system involvement and the diagnosis was ultimately made with tissue biopsy. Marked disease regression occurred after high-dose steroids and continued interleukin-6 inhibition.
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Affiliation(s)
- Samantha J. DeMarsh
- Division of Pediatric Residency ProgramNationwide Children’s HospitalColumbusOhioUSA
| | - Nicole E. Kendel
- Division of Pediatric Hematology‐OncologyNationwide Children’s HospitalColumbusOhioUSA
| | - Christine Bacha
- Division of Pediatric RheumatologyNationwide Children’s HospitalColumbusOhioUSA
| | - Stacy P. Ardoin
- Division of Pediatric RheumatologyNationwide Children’s HospitalColumbusOhioUSA
| | - Samir Kahwash
- Division of Pediatric PathologyNationwide Children’s HospitalColumbusOhioUSA
| | - Melissa J. Rose
- Division of Pediatric Hematology‐OncologyNationwide Children’s HospitalColumbusOhioUSA
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Kadoura L, Hamza A, Jobran AWM, Habes YMN, Agha S, Alyousfi R, Ayoub K. Unicentric Castleman disease in the mesentery with ambiguous symptoms: a rare case report. J Surg Case Rep 2021; 2021:rjab367. [PMID: 34457238 PMCID: PMC8390332 DOI: 10.1093/jscr/rjab367] [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: 06/21/2021] [Accepted: 08/04/2021] [Indexed: 11/14/2022] Open
Abstract
Castleman disease (CD) is a rare clinical entity characterized by enlarged lymph nodes. It may affect a single lymph node (unicentric) or multiple lymph nodes in the body (multicentric). However, it is exceptionally uncommon for unicentric Castleman disease (UCD) to present in the mesentery. Herein, we report a case of 38-year-old female complaining of polymenorrhea and abdominal discomfort for 4 months. Her past medical history was unremarkable; however, she has started smoking recently. The physical examination and radiography indicated a large, well-defined mass in the right hypochondrium. Eventually, the patient underwent laparotomy and the mass was excised totally. The Pathologic study confirmed the diagnosis as mesenteric CD, hyaline-vascular type. After 5 months of follow-up, the patient showed no evidence of recurrence. In conclusion, this case underscores the importance of taking mesenteric CD into consideration in each patient who presents with solid abdominal mass or ambiguous abdominal discomfort.
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Affiliation(s)
- Lama Kadoura
- Department of Surgery, Aleppo University Hospital, Aleppo, Syria
| | - Amr Hamza
- Correspondence address. Tel: 00963 962 084 481; E-mail:
| | | | | | - Sarab Agha
- Department of Pathology, Aleppo University Hospital, Aleppo, Syria
| | - Rama Alyousfi
- Department of Pathology, Aleppo University Hospital, Aleppo, Syria
| | - Kusay Ayoub
- Department of Surgery, Aleppo University Hospital, Aleppo, Syria
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Abstract
Lymphadenitis in the pediatric population frequently is benign and self-limited, often caused by infections. In children with refractory symptoms, lymph node biopsy may be indicated to rule out malignancy or obtain material for culture. Acute bacterial infections typically show a suppurative pattern of necrosis with abscess formation. Viral infections are associated with nonspecific follicular and/or paracortical hyperplasia. Granulomatous inflammation is associated with bacterial, mycobacterial, and fungal infections. Toxoplasma lymphadenitis displays follicular hyperplasia, monocytoid B-cell hyperplasia, and clusters of epithelioid histiocytes. Autoimmune and noninfectious inflammatory disorders are included in differential diagnosis of lymphadenitis. Infectious mononucleosis and Kikuchi-Fujimoto lymphadenitis may mimic Hodgkin and non-Hodgkin lymphomas.
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Affiliation(s)
- Maria Faraz
- Department of Health Sciences, McMaster University
| | - Flavia G N Rosado
- University of Texas Southwestern Medical Center, 2330 Inwood Road, Biocenter EB3.234, Dallas, TX 75390-9317, USA.
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Sopfe J, Endres A, Campbell K, Hayes K, Trout AT, Liang X, Lorsbach R, O’Brien MM, Cost CR. Castleman disease in pediatrics: Insights on presentation, treatment, and outcomes from a two-site retrospective cohort study. Pediatr Blood Cancer 2019; 66:e27613. [PMID: 30680887 PMCID: PMC6428598 DOI: 10.1002/pbc.27613] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 12/03/2018] [Accepted: 12/20/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Castleman disease (CD) is an uncommon lymphoproliferative disorder that is rare in pediatric populations; the literature describing this population is sparse. We sought to describe pediatric CD, including unicentric CD (UCD) and human herpes virus-8 (HHV8)-negative multicentric CD (MCD), in a multi-institutional cohort. METHODS We retrospectively reviewed 24 patients, aged 0 to 26 years at diagnosis, who were diagnosed with CD between January 1, 2005, and May 16, 2017, at two tertiary children's hospitals. Demographic and clinical data were collected. RESULTS Most patients (75%, 18/24) presented with UCD. All patients with MCD were HHV8-negative. The most common histopathologic variant was hyaline vascular (75%, 18/24). Plasma cell variant occurred in 33% (2/6 [95% confidence intervals (CI), 4-78%]) of patients with HHV8-negative MCD and 17% (3/18 [95% CI, 4-41%]) of patients with UCD. Systemic symptoms were present in 4 of 6 of patients with HHV8-negative MCD and 8 of 18 of patients with UCD. Anemia and laboratory inflammation occurred in both UCD and MCD patients, with nonsignificantly higher rates of anemia and elevated C-reactive protein in MCD patients. All but two UCD patients underwent gross total resection as definitive therapy. Among HHV8-negative MCD patients, a combination of resection, chemotherapy, and immunotherapy was used. No UCD patients and three of six HHV8-negative MCD patients experienced disease progression/relapse prior to lasting remission. There were no deaths. CONCLUSION Pediatric patients with CD most commonly have unicentric, hyaline vascular variant disease. Pediatric patients with both UCD and MCD commonly have systemic inflammation and, despite risk of progression/relapse in MCD patients, ultimately have excellent survival.
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Affiliation(s)
- Jenna Sopfe
- Center for Cancer and Blood Disorders, Department of Pediatrics, University of Colorado School of Medicine, 13123 E. 16 Ave, B115, Aurora, Colorado, 80045, USA, Phone: 720-777-1002, Fax: 720-777-7279
| | - Ashley Endres
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA, Phone: 513-736-3243, Fax: 866-466-9505
| | - Kristen Campbell
- Department of Pediatrics, University of Colorado School of Medicine, 13001 E 17th Pl, Building 500, N2228A, Aurora, Colorado, 80045, USA, Phone: 303-724-3400, Fax: None
| | - Kari Hayes
- Department of Radiology, University of Colorado School of Medicine, 13123 E. 16 AveB125, Aurora, Colorado, 80045, USA, Phone: 720-777-4525, Fax: 720-777-7264
| | - Andrew T. Trout
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA, Phone: 513-803-3004, Fax: 513-636-8145
| | - Xiayuan Liang
- Department of Pathology, University of Colorado School of Medicine, 13123 E. 16 Ave, B120, Aurora, Colorado, 80045, USA, Phone: 720-777-6266, Fax: 720-777-7119
| | - Robert Lorsbach
- Department of Pathology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, 45229, USA, Phone: 513-636-4261, Fax: 513-636-3924
| | - Maureen M. O’Brien
- Cancer and Blood Diseases Institute, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, 45229, USA, Phone: 513-803-1678, Fax: 513-636-3549
| | - Carrye R. Cost
- Center for Cancer and Blood Disorders, Department of Pediatrics, University of Colorado School of Medicine, 13123 E. 16 Ave, B115, Aurora, Colorado, 80045, USA, Phone: 720-777-6775, Fax: 720-777-7227
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Chen J, Yang C, Liang CZ. Detection of a unicentric type of Castleman-like mass at the site of adrenal grand: A case report and review of literature. World J Clin Cases 2018; 6:683-687. [PMID: 30430126 PMCID: PMC6232562 DOI: 10.12998/wjcc.v6.i13.683] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/26/2018] [Accepted: 10/09/2018] [Indexed: 02/05/2023] Open
Abstract
We present a case of adrenal CD in a 26-year-old female. The patient was referred to our hospital because of left flank pain for 1 wk. A computed tomography scan revealed a 4 cm × 3 cm well-defined mass, considered as a paraganglioma. A preoperative diagnosis of left adrenal neoplasm and urinary tract infection was made. The patient underwent anti-inflammatory therapy followed by an open operation to remove the mass in the left adrenal. Through analysis of the morphological pattern and immunohistochemical markers, a diagnosis of CD was made. During the 12-mo follow-up, there was no evidence of metastasis or recurrence. This case reminds clinicians that CD should be considered in the evaluation of an adrenal mass. Surgery is suggested for its therapeutic management.
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Affiliation(s)
- Jing Chen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Cheng Yang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Chao-Zhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
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Cousin E, Flodrops H, Boyer O, Hogan J, Ruin M, Couderc A, Goujon JM, Taque S. Renal failure in pediatric Castleman disease: Four French cases with thrombotic microangiopathy. Pediatr Blood Cancer 2018; 65:e27045. [PMID: 29603588 DOI: 10.1002/pbc.27045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/26/2018] [Accepted: 02/13/2018] [Indexed: 12/19/2022]
Abstract
Pediatric Castleman disease (CD) is an uncommon and poorly understood disorder of the lymph nodes. Renal failure has not been described in pediatric multicentric CD (MCD). We report four cases, who presented with polyadenopathy, organomegaly, edema and fluid accumulations, high blood pressure, and acute renal failure. In all cases, renal biopsy confirmed diffuse thrombotic microangiopathy. Definitive diagnosis of MCD was made by a biopsy of an affected lymph node located by computer tomography before initiation of corticosteroid therapy. Treatment of CD with corticosteroid therapy and rituximab was rapidly effective without relapse to date.
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Affiliation(s)
- Elie Cousin
- Department of Pediatrics, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Hugues Flodrops
- Department of Pediatrics, Centre Hospitalier Universitaire Saint Pierre de la Réunion, Saint Pierre, France
| | - Olivia Boyer
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire Necker-Enfant Malades, APHP, Institut Imagine, Université Paris Descartes, Paris, France
| | - Julien Hogan
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire Robert Debré, assistance publique des hôpitaux de Paris (APHP), Paris, France
| | - Mahe Ruin
- Department of Pediatrics, Centre Hospitalier Universitaire Saint Pierre de la Réunion, Saint Pierre, France
| | - Anne Couderc
- Department of Pediatric Nephrology, Centre Hospitalier Universitaire Robert Debré, assistance publique des hôpitaux de Paris (APHP), Paris, France
| | - Jean-Michel Goujon
- Department of Pathology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Sophie Taque
- Department of Pediatrics, Centre Hospitalier Universitaire de Rennes, Rennes, France
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Wala SJ, Fallon EM, Forlenza CJ, Shukla N, LaQuaglia MP. Unicentric Castleman disease in the mediastinum. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2018.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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10
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Rassouli N, Obmann VC, Sandhaus LM, Herrmann KA. (18F)-FDG-PET/MRI of unicentric retroperitoneal Castleman disease in a pediatric patient. Clin Imaging 2018; 50:175-180. [PMID: 29604602 DOI: 10.1016/j.clinimag.2018.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 02/20/2018] [Accepted: 03/09/2018] [Indexed: 02/08/2023]
Abstract
Castleman disease (CD) is a rare lymphoproliferative disorder of unknown etiology that may occur anywhere in the lymphatic system. Imaging plays an important role in detecting and staging this disease. Positron Emission Tomography/Magnetic Resonance Imaging (PET/MRI) combines the metabolic information derived from nuclear medical imaging with the high soft tissue resolution from MRI. We review the features of CD in standard diagnostic imaging, analyze the specific imaging findings of CD in FDG-PET/MRI and discuss a potential benefit of PET/MRI based on the case of a 15-year-old female patient with retroperitoneal CD.
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Affiliation(s)
- Negin Rassouli
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH 44106, USA
| | - Verena C Obmann
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH 44106, USA; Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital Bern, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland.
| | - Linda M Sandhaus
- Department of Pathology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave., Cleveland, OH 44106, USA.
| | - Karin A Herrmann
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH 44106, 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 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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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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Mantas D, Damaskos C, Dailiani P, Samarkos M, Korkolopoulou P. Castleman's disease of the spleen. Acta Chir Belg 2017; 117:203-208. [PMID: 27771992 DOI: 10.1080/00015458.2016.1246273] [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] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Castleman's disease (CD), also known as giant or angiofolicular lymphoid hyperplasia or lymphoid hamartoma, is a group of atypical lymphoproliferative disorders that share common lymph node histological features and may be localized either to a single lymph node (unicentric) or occur systemically (multicentric). PATIENT AND METHOD Herein, we present a rare case of a of 75-year-old female patient who was referred to our department and after a thorough work-up, underwent splenectomy with synchronous resection of an accessory spleen, splenic artery lymph nodes, and splenic hilar lymph nodes due to splenic involvement in a multicentric CD. RESULTS The pathology of the specimens led to the conclusion that it was a case of polycentric HHV-8-positive CD, affecting the spleen, the accessory spleen, and the lymph nodes. CONCLUSIONS Incidence of this rare condition is believed to be approximately 0.001-0.05%. CD has been linked to the human immunodeficiency virus (HIV), human herpes virus 8 (HHV-8), and is associated with malignancies. The pathogenesis mechanism is considered to be a dysregulation and hypersecretion of cytokines, either idiopathic or secondary to a viral infection, with the latter considered the most frequent. Solid organ involvement is very rare as is splenic involvement.
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Affiliation(s)
- Dimitrios Mantas
- 2nd Department of Propedeutic Surgery, Athens Medical School, National and Kapodistrian University of Athens, Goudi, Athens, Greece
| | - Christos Damaskos
- 2nd Department of Propedeutic Surgery, Athens Medical School, National and Kapodistrian University of Athens, Goudi, Athens, Greece
| | - Panagiota Dailiani
- Department of Pathology, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael Samarkos
- 1st Department of Internal Medicine, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Penelope Korkolopoulou
- Department of Pathology, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
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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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15
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Weis CA, Märkl B, Schuster T, Vollert K, Ströbel P, Marx A. [True thymic hyperplasia : Differential diagnosis of thymic mass lesions in neonates and children]. DER PATHOLOGE 2017; 38:286-293. [PMID: 28429039 DOI: 10.1007/s00292-017-0283-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Reactive and neoplastic thymic pathologies are the main considerations in the case of masses in the anterior and middle part of the mediastinum, while neurogenic tumors are predominant in the posterior mediastinum (which are not dealt with here). In neonates and infants, the commonest pathologies in the anterior mediastinum comprise germ cell tumors (mainly teratomas), congenital thymic cysts and true thymic hyperplasia (TTH). In toddlers, teratomas, yolk sac tumors and cysts predominate. In children over 5 years of age, lymphomas are the commonest mass lesions whereas thymomas and thymic carcinomas are rare. In addition, inflammation-linked hyperplasia in myasthenia gravis and rebound thymic hyperplasia after chemotherapy must be considered. Although rare at all ages, sarcomas must be considered in the differential diagnosis from birth onwards and throughout adolescence. Based on the report of a rare case of recurrent TTH, the differential diagnosis of this benign but potentially life-threatening condition is discussed.
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Affiliation(s)
- C-A Weis
- Pathologisches Institut, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
| | - B Märkl
- Institut für Pathologie, Klinikum Augsburg, Augsburg, Deutschland
| | - T Schuster
- Kinderchirurgische Klinik, Klinikum Augsburg, Augsburg, Deutschland
| | - K Vollert
- Klinik für Diagnostische Radiologie und Neuroradiologie, Klinikum Augsburg, Augsburg, Deutschland
| | - P Ströbel
- Institut für Pathologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - A Marx
- Pathologisches Institut, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
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16
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Affiliation(s)
- Rajendra Prasad Takhar
- Department of Respiratory Medicine, Government Medical College, Kota, Rajasthan, India. E-mail:
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17
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Hamilton J, Mandel L. Rare Submandibular Presentation of Pediatric Castleman Disease: Case Report. J Oral Maxillofac Surg 2016; 75:763-766. [PMID: 27870926 DOI: 10.1016/j.joms.2016.10.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/10/2016] [Accepted: 10/13/2016] [Indexed: 02/05/2023]
Abstract
Castleman disease (CD), a benign lymphoproliferative disorder that affects lymph nodes, is uncommon in children, with only approximately 100 cases published. Although 23% of pediatric CD cases are found in the neck, there is no substantial reported percentage found in the salivary glands, especially the submandibular salivary gland (SMSG). A pediatric case of CD involving the SMSG is reported because of its extreme rarity.
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Affiliation(s)
- Jodi Hamilton
- Research Assistant, Salivary Gland Center; Fourth-Year Student, Columbia University College of Dental Medicine, Columbia University College of Dental Medicine and Salivary Gland Center, New York, NY
| | - Louis Mandel
- Director, Salivary Gland Center; Associate Dean, Clinical Professor, Department of Oral and Maxillofacial Surgery, Columbia University College of Dental Medicine, Columbia University College of Dental Medicine and Salivary Gland Center, New York, NY.
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18
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Akman AO, Basaran O, Ozyoruk D, Han U, Sayli T, Cakar N. Atypical presentation of multicentric Castleman disease in a pediatric patient: pleural and pericardial effusion. Eur J Pediatr 2016; 175:873-6. [PMID: 26614115 DOI: 10.1007/s00431-015-2674-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 11/15/2015] [Accepted: 11/19/2015] [Indexed: 10/22/2022]
Abstract
UNLABELLED Castleman disease (CD) is a rare poorly understood lymphoproliferative disorder. Pediatric onset CD has been reported before. However, most of them have benign unicentric pattern. Multicentric CD (MCD) is quite rare in children. Herein, we report a 13-year-old adolescent boy with MCD of the hyaline vascular variant presenting with pleural and pericardial effusion, which is an uncommon presentation. CONCLUSION MCD should be considered in the differential diagnosis of pleural and/or pericardial effusion with unexplained lymph nodes in children. What is Known •Pediatric Castleman disease (CD) most commonly occurs in the unicentric form, which typically is asymptomatic and cured by lymph node excision. •The diagnosis of MCD can be difficult owing to the heterogeneity of presentation and potential for nonspecific multisystem involvement. What is New •A 13-year-old adolescent boy was diagnosed with MCD of the hyaline vascular variant presenting with pleural and pericardial effusion, which is an uncommon presentation. •In a pediatric patient with fever, pleural-pericardial effusion and multiple lymph nodes, MCD should be considered in differantial diagnosis.
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Affiliation(s)
- Alkim Oden Akman
- Department of General Pediatrics, Ankara Children's Hematology and Oncology Training Hospital, Ankara, Turkey. .,Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim Araştırma Hastanesi, İrfan Baştuğ Caddesi Ziraat Mahallesi Altındağ, Ankara, Turkey.
| | - Ozge Basaran
- Department of Pediatric Rheumatology, Ankara Children's Hematology and Oncology Training Hospital, Ankara, Turkey
| | - Derya Ozyoruk
- Department of Pediatric Oncology, Ankara Children's Hematology and Oncology Training Hospital, Ankara, Turkey
| | - Unsal Han
- Department of Pathology & Cytology, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Tulin Sayli
- Department of Pediatric Hematology, Ankara Children's Hematology and Oncology Training Hospital, Ankara, Turkey
| | - Nilgun Cakar
- Department of Pediatric Rheumatology, Ankara Children's Hematology and Oncology Training Hospital, Ankara, Turkey
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19
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Chung EM, Biko DM, Arzamendi AM, Meldrum JT, Stocker JT. Solid Tumors of the Peritoneum, Omentum, and Mesentery in Children: Radiologic-Pathologic Correlation:From the Radiologic Pathology Archives. Radiographics 2015; 35:521-46. [DOI: 10.1148/rg.352140273] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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20
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Multicentric Castleman's Disease in a Child Revealed by Chronic Diarrhea. Case Rep Pediatr 2015; 2015:689206. [PMID: 25737793 PMCID: PMC4337035 DOI: 10.1155/2015/689206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 01/30/2015] [Indexed: 11/24/2022] Open
Abstract
Multicentric Castleman's disease is a rare benign and unexplained lymphoproliferative disorder that is extremely uncommon in children. It presents with fever, systemic symptoms, generalized lymphadenopathy, and laboratory markers of inflammation. Its treatment is not standardized and its prognosis is poor. We report a novel case of multicentric Castleman's disease in a 13-year-old girl who had presented with chronic diarrhea as the only initial presenting symptom. The diagnosis of celiac or inflammatory bowel diseases was suspected, but two and a half years later, the diagnosis of multicentric Castleman's disease was brought following the appearance of abdominal mass whose biopsy revealed Castleman's disease in the plasma cell form. The outcome was favorable after treatment by corticosteroid, chemotherapy, and surgery. The occurrence of diarrhea as the initial symptom of multicentric Castleman's disease without lymph node involvement is very rare. This case report underlines the diagnostic difficulties and the long interval between onset and diagnosis when diarrhea occurs first.
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21
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Nagabushana D, Benakappa A. Multicentric Castleman's disease presenting with recurrent infections, rash, and malnutrition. Clin Pediatr (Phila) 2014; 53:906-7. [PMID: 24065736 DOI: 10.1177/0009922813504027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Asha Benakappa
- Bangalore Medical College and Research Institute, Bangalore, India
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22
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Zawawi F, Varshney R, Haegert DG, Daniel SJ. Castleman's Disease: a rare finding in a pediatric neck. Int J Pediatr Otorhinolaryngol 2014; 78:370-2. [PMID: 24332608 DOI: 10.1016/j.ijporl.2013.11.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 11/13/2013] [Accepted: 11/17/2013] [Indexed: 12/31/2022]
Abstract
Castleman's Disease is a rare lymphoproliferative disorder. In the literature, only 29 cases, associated with the neck presentation in children, have been reported. This is another case report regarding a 5-year old child who presented with a persistent cervical lymphadenopathy. Final pathology, after undergoing exploratory neck dissection and surgical excision, revealed Castleman's Disease. This report, augmented with a literature review of all the 29 cases, compares the clinical course of this patient with the other cases. In conclusion, although Castleman's Disease carries a favorable prognosis in children, surgical excision is recommended to confirm the diagnosis and to rule out other causes.
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Affiliation(s)
- Faisal Zawawi
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada; King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Rickul Varshney
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada
| | - David G Haegert
- Department of Pathology, McGill University, Montreal, QC, Canada
| | - Sam J Daniel
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada.
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23
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Slater BJ, Nordin AB, Allen CE, Elghetany MT, Heinle JS, Kim ES. Resection of mediastinal castleman's disease: a case report. Pediatr Hematol Oncol 2013; 30:554-6. [PMID: 23301538 DOI: 10.3109/08880018.2012.753494] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Bethany J. Slater
- 1Department of Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
- 3Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Andrew B. Nordin
- 1Department of Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
- 3Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Carl E. Allen
- 2Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
- 3Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - M. Tarek Elghetany
- 2Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
- 3Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey S. Heinle
- 1Department of Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
- 3Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Eugene S. Kim
- 1Department of Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
- 3Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
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24
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Alavi A, Asadi Gharabaghi M. Unicentric Castleman's disease: an uncommon cause of posterior mediastinal mass. BMJ Case Rep 2013; 2013:bcr-2012-008522. [PMID: 23761562 DOI: 10.1136/bcr-2012-008522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Castleman's disease is a rare lymphoproliferative disease that may be unicentric or multicentric in presentation. It may develop anywhere along with the lymphatic system such as the abdomen, neck and thoracic cavity. However, mediastinum is the most common location for unicentric disease. Here, we discuss a unicentric Castleman's disease in a 28-year-old woman who presented with cough, mild dysphagia and a large posterior mediastinal mass.
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Affiliation(s)
- Aliasghar Alavi
- Department of Thoracic Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
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25
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Rabinowitz MR, Levi J, Conard K, Shah UK. Castleman disease in the pediatric neck: a literature review. Otolaryngol Head Neck Surg 2013; 148:1028-36. [PMID: 23459702 DOI: 10.1177/0194599813479931] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate the common features of cervical pediatric Castleman disease. DATA SOURCES Literature review of pediatric patients with cervical Castleman disease. REVIEW METHODS Online medical journal databases were searched for patients aged 18 years or younger. Eighteen published studies were found, comprising 29 patients. CONCLUSIONS An asymptomatic or slowly enlarging neck mass was the most common presentation. No sex differences were noted. Magnetic resonance imaging demonstrates a homogeneous, isointense to slightly hyperintense T1-weighted signal and high signal intensity on T2-weighted imaging. Lymphoma was the most common differential diagnosis. All patients were treated with complete surgical excision and diagnosed as hyaline-vascular type on histology, except for 1 patient for whom histologic type was not reported. No reports of multicentric disease, plasma cell, or mixed histology were found. No recurrences were reported. IMPLICATIONS FOR PRACTICE In this article, we provide the largest known literature review of pediatric patients with cervical Castleman disease. Although Castleman disease is rare, it should be considered on the differential for a pediatric neck mass, particularly when presenting with an asymptomatic posterior neck mass and equivocal workup. Fortunately, our study suggests that if diagnosed as Castleman disease, the most likely diagnosis is hyaline-vascular type, for which the long-term prognosis is good. Surgical excision is both diagnostic and therapeutic.
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Affiliation(s)
- Mindy R Rabinowitz
- Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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Vianna PM, Pastore PG, Cristofani L, Siqueira SAC, Aldred V, de Campos FPF, Zerbini MCN. Castleman disease: an uncommon diagnosis in pediatrics. AUTOPSY AND CASE REPORTS 2012; 2:39-44. [PMID: 31528578 PMCID: PMC6735562 DOI: 10.4322/acr.2012.024] [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: 07/13/2012] [Accepted: 08/28/2012] [Indexed: 11/23/2022] Open
Abstract
First described by Dr. Benjamin Castleman in 1956, Castleman disease is an uncommon disease of an etiology that is not yet thoroughly known. Three distinct histological subtypes have already been described: hyaline-vascular-, plasma cell-, and human herpes virus 8-associated variant, clinically distinguished in multi or unicentric types. Castleman disease is occasionally diagnosed in children, but more often in young adults, with no gender predominance. The symptoms are rather heterogeneous, varying from an asymptomatic mass in the unicentric Castleman disease type, to life-threatening systemic inflammatory state with systemic symptoms in the multicentric Castleman disease type. The authors report a case of a 15-year-old boy who sought medical attention due to a cervical tumor mass, without systemic symptoms. Pathology exam of the excised mass diagnosed a very typical example of the hyaline-vascular unicentric type of Castleman disease.
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Affiliation(s)
- Paula Martinez Vianna
- Department of Pathology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Paulo Galluzzi Pastore
- Department of Pathology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Lilian Cristofani
- Department of Pediatrics - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
| | | | - Vera Aldred
- Department of Pathology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
| | | | - Maria Claudia Nogueira Zerbini
- Department of Pathology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil.,Anatomic Pathology Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
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