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K A M, Kota SR, Mudigonda N, Kumar G, Abuji K. Mesenteric Castleman Disease Mimicking Neuroendocrine Tumor. Cureus 2024; 16:e61549. [PMID: 38962652 PMCID: PMC11219578 DOI: 10.7759/cureus.61549] [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] [Accepted: 05/31/2024] [Indexed: 07/05/2024] Open
Abstract
Castleman disease (CD) is a benign lymphoproliferative disorder of unknown etiology, which can involve any part of the body. CD can involve a single lymph node (unicentric) or multiple lymph nodes (multicentric) of which unicentric CD is the most common type. The unicentric CD is usually localized, asymptomatic, and often appears as an incidental mass on radiographs, whereas multicentric CD is characterized by systemic involvement. Mesenteric involvement of CD is very rare. In this article, we present a case of the unicentric CD of small bowel mesentery, which mimicked a neuroendocrine tumor preoperatively.
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Affiliation(s)
- Manjesh K A
- General Surgery, ESIC (Employee's State Insurance Corporation) Medical College, Hyderabad, IND
| | - Sreedhar Rao Kota
- General Surgery, ESIC (Employee's State Insurance Corporation) Medical College, Hyderabad, IND
| | - Narender Mudigonda
- General Surgery, ESIC (Employee's State Insurance Corporation) Medical College, Hyderabad, IND
| | - Gokul Kumar
- General Surgery, ESIC (Employee's State Insurance Corporation) Hospital, Hyderabad, IND
| | - Kishore Abuji
- General Surgery, ESIC (Employee's State Insurance Corporation) Medical College, Hyderabad, IND
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2
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Intagliata E, Vecchio R, Vizzini C, Villari L, Cacciola RR, Cacciola E, Vecchio V. Retroperitoneal paraduodenal unicentric Castleman disease: case report and review of the literature. J Surg Case Rep 2024; 2024:rjae073. [PMID: 38370604 PMCID: PMC10873855 DOI: 10.1093/jscr/rjae073] [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: 10/24/2023] [Accepted: 01/25/2024] [Indexed: 02/20/2024] Open
Abstract
Castleman disease is a rare and benign disorder, characterized by enlarged lymph nodes and angiofollicular lymphoid hyperplasia. We report a case of a 57-year-old male, who was admitted to our surgical department because of a retroperitoneal nodular mass measuring about 4 cm in maximum diameter, incidentally discovered on a radiologic exam performed for the onset of vague abdominal pain with posterior irradiation. The patient was subdue to laparoscopic removal of the mass and no intra- and post-operative complications were recorded. Histologic diagnosis of hyaline-vascular variant of the Castleman disease was confirmed. Only two cases have been found in the literature reporting the paraduodenal unicentric Castleman disease localization like our case. Although rare, the Castleman disease must be considered in the differential diagnosis among all the lymph nodes diseases, for avoiding improper therapies.
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Affiliation(s)
- Eva Intagliata
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Policlinico “G. Rodolico—San Marco”, Via S. Sofia 78, 95123 Catania, Italy
| | - Rosario Vecchio
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Policlinico “G. Rodolico—San Marco”, Via S. Sofia 78, 95123 Catania, Italy
| | - Clarissa Vizzini
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Policlinico “G. Rodolico—San Marco”, Via S. Sofia 78, 95123 Catania, Italy
| | - Loredana Villari
- Pathological Anatomy Unit, University of Catania, Italy Policlinico “G. Rodolico—San Marco”, Via S. Sofia 78, 95123 Catania, Italy
| | - Rossella Rosaria Cacciola
- Department of Biomedical Science, Hematologic Unit, University of Catania, Policlinico “G. Rodolico—San Marco”, Via S. Sofia 78, 95123 Catania, Italy
| | - Emma Cacciola
- Department of Medical Sciences, Surgical Sciences and Advanced Technologies, Hemostasis Unit, University of Catania, Italy, Policlinico “G. Rodolico—San Marco”, Via S. Sofia 78, 95123 Catania, Italy
| | - Veronica Vecchio
- Department of Biomedical Science, Hematologic Unit, University of Catania, Policlinico “G. Rodolico—San Marco”, Via S. Sofia 78, 95123 Catania, Italy
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3
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Gao JW, Shi ZY, Zhu ZB, Xu XR, Chen W. Intraperitoneal hyaline vascular Castleman disease: Three case reports. World J Clin Cases 2023; 11:8527-8534. [PMID: 38188201 PMCID: PMC10768503 DOI: 10.12998/wjcc.v11.i36.8527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/27/2023] [Accepted: 12/13/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND Castleman disease (CD) was first reported in 1954. It is a rare non-malignant lymphoproliferative disease with unclear etiology. As the clinical manifestations of CD are different, there are difficulties in its diagnosis and treatment. Therefore, for patients with CD, it is important to establish the diagnosis in order to choose the appropriate treatment. CASE SUMMARY In this report, three patients with intraperitoneal CD treated at our center from January 2018 to June 2023 were reviewed, and the clinical and paraclinical examinations, diagnosis, and treatment were analyzed, and all three patients were diagnosed with CD by routine histopathological and immunohistochemical examinations. CONCLUSION CD is a complex and rare disease. Because there are no special clinical symptoms and laboratory abnormalities, the diagnosis often depends on routine pathological and immunohistochemical findings.
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Affiliation(s)
- Jia-Wei Gao
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
| | - Zhe-Yi Shi
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
| | - Zhao-Bi Zhu
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
| | - Xiang-Rong Xu
- Department of General Surgery, Kunshan Hospital Affiliated to Jiangsu University, Suzhou 215300, Jiangsu Province, China
| | - Wei Chen
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
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Dev S, Pokhrel KM, Pokharel P, Bhandari RS, Pradhan S. Castleman disease of the pancreas mimicking pancreatic neuroendocrine tumor: A rare case report. Int J Surg Case Rep 2023; 109:108524. [PMID: 37481971 PMCID: PMC10369461 DOI: 10.1016/j.ijscr.2023.108524] [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: 05/15/2023] [Revised: 07/01/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023] Open
Abstract
INTRODUCTION Castleman's disease (CD) of the pancreas is a rare benign disease which can sometime resemble a pancreatic neuroendocrine tumor. PRESENTATION OF THE CASE We report a case of a 46-years-old lady with an incidental pancreatic lesion. Preoperative diagnosis was a neuroendocrine tumor of the pancreas, for which anterior Radical Antegrade Modular Pancreatosplenectomy surgery (RAMPs) was performed. The postoperative histopathology showed features consistent with hyaline vascular type Castleman's disease. She had an uneventful surgical procedure and no serious postoperative complications. DISCUSSION Pancreatic Castleman's disease is usually difficult to diagnose and there is no specific clinical manifestation to distinguish it from a neuroendocrine tumor. Even with radiological imaging it is very difficult to distinguish Castleman's disease from neuroendocrine tumors, and the preoperative imaging diagnosis may not match with the postoperative histopathological diagnosis. Treatment of CD is surgical resection and has a good prognosis. Partial resection and radiation therapy or observation alone is an alternative to complete surgical resection. CONCLUSION Castleman disease of the pancreas sometimes mimics neuroendocrine tumors of the pancreas. Clinicians should consider Castleman's disease of the pancreas as a differential diagnosis for neuroendocrine like lesions of the pancreas.
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Affiliation(s)
- Santosh Dev
- Department of General Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Kailash Mani Pokhrel
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Pashupati Pokharel
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
| | - Ramesh Singh Bhandari
- Department of Surgical Gastroenterology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Sumita Pradhan
- Department of Surgical Gastroenterology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
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5
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Di Nuzzo MM, Visconti M, Magno G, Di Santo Albini AG, Peltrini R, Corcione F. Totally laparoscopic management of retrocaval metastatic melanoma in a young patient: a video vignette. G Chir 2023; 43:e22. [DOI: 10.1097/ia9.0000000000000022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2024]
Affiliation(s)
| | - Marco Visconti
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Giuseppe Magno
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Roberto Peltrini
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Francesco Corcione
- Department of Public Health, University of Naples Federico II, Naples, Italy
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Molacek J, Treska V, Skalicky T, Vodicka J, Ferda J, Ferdova E, Baxa J, Mach C, Jungova A, Michal M. Unicentric form of Castleman´s disease, pitfalls of diagnosis and surgical treatment. Front Oncol 2023; 13:1057683. [PMID: 36793610 PMCID: PMC9923952 DOI: 10.3389/fonc.2023.1057683] [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: 09/29/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
Background Castleman´s disease is an extremely rare heterogenous lymphoproliferative pathology with a mostly benign behavior. It is a localized or generalized lymph node enlargement of an unknown aetiology. Unicentric form is typically a slow-growing solitary mass occurring mostly in the mediastinum, abdominal cavity, retroperitoneum, pelvis and neck. Aetiology and pathogenesis of CD is probably diverse, varying in different types of this heterogeneous disease. Materials and Methods Authors present a review of this issue based on their extensive experience. The aim is to summarize the crucial factors in the management of diagnostics and a surgical treatment of the unicentric form of Castleman´s disease. One of the key issues in the unicentric form is precise preoperative diagnostics and thus choosing the right surgical treatment strategy. Authors highlight pitfalls of the diagnosis and surgical treatment. Results All histological types such as a hyaline vascular type, plasmacytic type and a mixed type are presented as well as options of surgical and conservative treatment. Differential diagnosis and malignant potential is discussed. Conclusion Patients with Castleman´s disease should be treated in the high- volume centers, with a great experience in major surgical procedures as well as with preoperative imaging diagnostic techniques. Specialized pathologists and oncologists focusing on this issue are also absolutely necessary to avoid misdiagnosis. Only this complex approach can lead to excellent outcomes in patients with UCD.
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Affiliation(s)
- Jiri Molacek
- Faculty of Medicine in Pilsen, Charles University, Plzen, Czechia.,Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Vladislav Treska
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Tomas Skalicky
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Josef Vodicka
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Jiri Ferda
- Department of Imaging Methods, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Eva Ferdova
- Department of Imaging Methods, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Jan Baxa
- Department of Imaging Methods, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Christiana Mach
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Alexandra Jungova
- Department of Hematology and Oncology, University Hospital in Pilsen, Plzen, Czechia
| | - Michael Michal
- Faculty of Medicine in Pilsen, Charles University, Plzen, Czechia
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Bracale U, Peltrini R, De Luca M, Ilardi M, Di Nuzzo MM, Sartori A, Sodo M, Danzi M, Corcione F, De Werra C. Predictive Factors for Anastomotic Leakage after Laparoscopic and Open Total Gastrectomy: A Systematic Review. J Clin Med 2022; 11:jcm11175022. [PMID: 36078954 PMCID: PMC9457286 DOI: 10.3390/jcm11175022] [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: 07/29/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this systematic review is to identify patient-related, perioperative and technical risk factors for esophago-jejunal anastomotic leakage (EJAL) in patients undergoing total gastrectomy for gastric cancer (GC). A comprehensive literature search of PubMed/MEDLINE, Embase and Scopus databases was performed. Studies providing factors predictive of EJAL by uni- and multivariate analysis or an estimate of association between EJAL and related risk factors were included. All studies were assessed for methodological quality, and a narrative synthesis of the results was performed. A total of 16 studies were included in the systematic review, with a total of 42,489 patients who underwent gastrectomy with esophago-jejunal anastomosis. Age, BMI, impaired respiratory function, prognostic nutritional index (PNI), alcohol consumption, chronic renal failure, diabetes and mixed-type histology were identified as patient-related risk factors for EJAL at multivariate analysis. Likewise, among operative factors, laparoscopic approach, anastomosis type, additional organ resection, blood loss, intraoperative time and surgeon experience were found to be predictive factors for the development of EJAL. In clinical setting, we are able to identify several risk factors for EJAL. This can improve the recognition of higher-risk patients and their outcomes.
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Affiliation(s)
- Umberto Bracale
- Department of Advanced Biomedical Sciences, Federico II University Hospital, 80131 Naples, Italy
| | - Roberto Peltrini
- Department of Public Health, Federico II University Hospital, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-081-7462734
| | - Marcello De Luca
- Department of Public Health, Federico II University Hospital, 80131 Naples, Italy
| | - Mariangela Ilardi
- Department of Public Health, Federico II University Hospital, 80131 Naples, Italy
| | | | - Alberto Sartori
- Department of Surgery, San Valentino Montebelluna Hospital, 31044 Treviso, Italy
| | - Maurizio Sodo
- Department of Public Health, Federico II University Hospital, 80131 Naples, Italy
| | - Michele Danzi
- Department of Public Health, Federico II University Hospital, 80131 Naples, Italy
| | - Francesco Corcione
- Department of Public Health, Federico II University Hospital, 80131 Naples, Italy
| | - Carlo De Werra
- Department of Advanced Biomedical Sciences, Federico II University Hospital, 80131 Naples, Italy
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Miratashi Yazdi SA, Nazar E. Retroperitoneal Unicentric Castleman's disease, a case report. Ann Med Surg (Lond) 2022; 79:104109. [PMID: 35860095 PMCID: PMC9289496 DOI: 10.1016/j.amsu.2022.104109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/26/2022] [Accepted: 06/26/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Castleman's disease (CD) is an unusual nonmalignant lymphoproliferative disorder which presented with enlarged hyperplastic lymphoid tissue and had three subtypes, hyaline-vascular, plasma cell, and mixed form according to histologic findings. Case report We report a 31-year-old woman who presented with abdominal pain from 3 months ago. Imaging studies showed a well-defined mass on back of pancreas without any invasion. The histopathological examination revealed lymphoid tissue with prominent vascular proliferation and hyalinization of the vessel walls compatible with Hyaline vascular CD. So, pathological assessment is essential for the diagnosis. Conclusion Unicentric CD must be considered as differential diagnosis in a solid solitary abdominal mass. In patients with abdominal mass of an ambiguous nature, surgical resection is necessary as diagnostic tool and the first treatment approach. Castleman's disease is an unusual nonmalignant lymphoproliferative disorder. Unicentric Castleman's disease must be considered as differential diagnosis in a solid solitary abdominal mass. Surgical resection is necessary and adequate for diagnosis and treatment of patients.
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9
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Gou H, Fan J, Luo M, Liu S, Yang X, He K. Castleman Disease Misdiagnosed as Pancreatic Neuroendocrine Tumor by Fine Needle Aspiration Biopsy. Am Surg 2022:31348221102606. [PMID: 35544955 DOI: 10.1177/00031348221102606] [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: 11/15/2022]
Abstract
Castleman disease (CD) is a lymphoproliferative disorder that rarely occurs in the pancreas. We reported a 46-year-old man was admitted to our hospital due to recurrent minor epigastric pain for 7 days. The abdominal enhanced CT showed irregular foci in the body of the pancreas with abundant blood supply considered a neuroendocrine tumor. The patient was subsequently diagnosed with pancreatic neuroendocrine tumor by an ultrasound-guided fine needle aspiration biopsy. Therefore, he underwent an open pancreatic mass resection. The ultimate diagnosis was CD and belonged to hyaline vascular type based on the postoperative pathology. After a 13-month follow-up, no recurrence of abdominal pain or lesions was observed. This case suggests that fine needle aspiration biopsy is not conclusive and unsuitable for pancreatic CD and highlights the importance of routine pathology due to the absence of typical signs and symptoms.
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Affiliation(s)
- Haoxian Gou
- Department of General Surgery (Hepatobiliary Surgery), 556508The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China.,Academician Expert Workstation of Sichuan Province, Luzhou, China
| | - Jun Fan
- Department of General Surgery (Hepatobiliary Surgery), 556508The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Ming Luo
- Department of General Surgery (Hepatobiliary Surgery), 556508The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Shenglu Liu
- Department of General Surgery (Hepatobiliary Surgery), 556508The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiaoli Yang
- Department of General Surgery (Hepatobiliary Surgery), 556508The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Kai He
- Department of General Surgery (Hepatobiliary Surgery), 556508The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China.,Academician Expert Workstation of Sichuan Province, Luzhou, China
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Di Nuzzo MM, De Werra C, Pace M, Franca RA, D’Armiento M, Bracale U, Lionetti R, D’Ambra M, Calogero A. Promoting Laparoscopic Anterior Approach for a Very Low Presacral Primary Neuroendocrine Tumor Arising in a Tailgut Cyst. Healthcare (Basel) 2022; 10:healthcare10050805. [PMID: 35627942 PMCID: PMC9141776 DOI: 10.3390/healthcare10050805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/13/2022] [Accepted: 04/25/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Tailgut cysts are rare congenital lesions that develop in the presacral space. As they can potentially conceal primary neuroendocrine tumors, surgical excision is suggested as the treatment of choice. However, specific management guidelines have yet to be developed. A posterior approach is usually preferred for cysts extending to the third sacral vertebral body. Conversely, a transabdominal approach is preferred for lesions extending upward to achieve an optimal view of the surgical field and avoid injuries. Case report: Here, we report a case of a 48-year-old man suffering from perianal pain and constipation. Digital rectal examination and magnetic resonance imaging revealed a presacral mass below the third sacral vertebral body. A laparoscopic transabdominal presacral tumor excision was performed. The final histological diagnosis was a rare primary neuroendocrine tumor arising from a tailgut cyst. The postoperative course was uneventful, and no signs of recurrence were observed at the six-month follow-up. Conclusions: This study may help establish more well-grounded recommendations for the surgical management of rectal tumors, demonstrating that the laparoscopic transabdominal technique is safe and feasible, even for lesions below the third sacral vertebral body. This approach provided an adequate view of the presacral space, facilitating the preservation of cyst integrity, which is essential in cases of malignant pathologies.
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Affiliation(s)
- Maria Michela Di Nuzzo
- Department of Public Health, University of Naples Federico II, 80138 Naples, Italy; (C.D.W.); (M.D.); (U.B.); (R.L.); (M.D.); (A.C.)
- Correspondence: ; Tel.: +39-33-8936-9828
| | - Carlo De Werra
- Department of Public Health, University of Naples Federico II, 80138 Naples, Italy; (C.D.W.); (M.D.); (U.B.); (R.L.); (M.D.); (A.C.)
| | - Mirella Pace
- Department of Biomorfological and Functional Sciences, University of Naples Federico II, 80138 Naples, Italy; (M.P.); (R.A.F.)
| | - Raduan Ahmed Franca
- Department of Biomorfological and Functional Sciences, University of Naples Federico II, 80138 Naples, Italy; (M.P.); (R.A.F.)
| | - Maria D’Armiento
- Department of Public Health, University of Naples Federico II, 80138 Naples, Italy; (C.D.W.); (M.D.); (U.B.); (R.L.); (M.D.); (A.C.)
| | - Umberto Bracale
- Department of Public Health, University of Naples Federico II, 80138 Naples, Italy; (C.D.W.); (M.D.); (U.B.); (R.L.); (M.D.); (A.C.)
| | - Ruggero Lionetti
- Department of Public Health, University of Naples Federico II, 80138 Naples, Italy; (C.D.W.); (M.D.); (U.B.); (R.L.); (M.D.); (A.C.)
| | - Michele D’Ambra
- Department of Public Health, University of Naples Federico II, 80138 Naples, Italy; (C.D.W.); (M.D.); (U.B.); (R.L.); (M.D.); (A.C.)
| | - Armando Calogero
- Department of Public Health, University of Naples Federico II, 80138 Naples, Italy; (C.D.W.); (M.D.); (U.B.); (R.L.); (M.D.); (A.C.)
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Gündüz E, Kırkızlar HO, Ümit EG, Karaman Gülsaran S, Özkocaman V, Özkalemkaş F, Candar Ö, Elverdi T, Küçükyurt S, Paydaş S, Ceneli Ö, Karakuş S, Maral S, Ekinci Ö, İpek Y, Kis C, Güven ZT, Akdeniz A, Celkan T, Eroğlu Küçükdiler AH, Akgün Çağlıyan G, Özçelik Şengöz C, Karataş A, Bulduk T, Özcan A, Belen Apak FB, Canbolat A, Kartal İ, Ören H, Töret E, Özdemir GN, Bakanay Öztürk ŞM. Castleman Disease: A Multicenter Case Series from Turkey. Turk J Haematol 2022; 39:130-135. [PMID: 35176839 PMCID: PMC9160699 DOI: 10.4274/tjh.galenos.2022.2021.0670] [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] [Indexed: 12/01/2022] Open
Abstract
Objective: Castleman disease (CD) is a rare disease also known as angiofollicular lymph node hyperplasia. The two main histological subtypes are the hyaline vascular and plasma cell variants. It is further classified as unicentric CD (UCD) or multicentric CD (MCD) according to the anatomical distribution of the disease and the number of lymph nodes involved. The aim of this multicenter study was to evaluate all cases of CD identified to date in Turkey to set up a national registry to improve the early recognition, treatment, and follow-up of CD. Materials and Methods: Both adult (n=130) and pediatric (n=10) patients with lymph node or involved field biopsy results reported as CD were included in the study. Patients’ demographic information, clinical and laboratory characteristics, imaging study results, treatment strategies, and clinical outcomes were evaluated retrospectively. Results: A total of 140 patients (69 male and 71 female) with a diagnosis of UCD (n=73) or MCD (n=67) were included. The mean age was 39 years in the UCD group and 47 years in the MCD group. Female patients were more common in the UCD group. The most common histological subtype was hyaline vascular for both UCD and MCD patients. Asymptomatic patients were more common in the UCD group. Anemia, elevations of acute phase reactants, and hypoalbuminemia were more common in the MCD group. The most commonly used treatment strategies for UCD were surgical excision, rituximab, and radiotherapy, respectively. All UCD patients were alive at a median of 19.5 months of follow-up. The most commonly used treatment strategies for MCD were methyl prednisolone, R-CHOP, R-CVP, and rituximab. Thirteen MCD patients had died at a median of 34 months of follow-up. Conclusion: This study is important in presenting the patient characteristics and treatment strategies for CD from Turkey, with the potential of increasing awareness about CD. Treatment data may help in making decisions, particularly in countries that do not have access to siltuximab. However, larger prospective studies are needed to make definitive conclusions.
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Affiliation(s)
- Eren Gündüz
- Eskişehir Osmangazi University Faculty of Medicine Department of Hematology, Eskişehir, Turkey
| | | | - Elif Gülsüm Ümit
- Trakya University Faculty of Medicine Department of Hematology, Edirne, Turkey
| | | | - Vildan Özkocaman
- Uludag University Faculty of Medicine Department of Hematology, Bursa, Turkey
| | - Fahir Özkalemkaş
- Uludag University Faculty of Medicine Department of Hematology, Bursa, Turkey
| | - Ömer Candar
- Uludag University Faculty of Medicine Department of Hematology, Bursa, Turkey
| | - Tuğrul Elverdi
- İstanbul University Cerrahpaşa Faculty of Medicine Department of Hematology, İstanbul, Turkey
| | - Selin Küçükyurt
- İstanbul University Cerrahpaşa Faculty of Medicine Department of Hematology, İstanbul, Turkey
| | - Semra Paydaş
- Çukurova University Faculty of Medicine Department of Hematology, Adana, Turkey
| | - Özcan Ceneli
- Necmettin Erbakan University Meram Faculty of Medicine Department of Hematology, Konya, Turkey
| | - Sema Karakuş
- Ankara Başkent University Faculty of Medicine Department of Hematology, Ankara, Turkey
| | - Senem Maral
- Health Sciences University Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Ömer Ekinci
- Fırat University Faculty of Medicine Department of Hematology, Elazığ, Turkey
| | - Yıldız İpek
- Kartal Dr Lutfi Kirdar City Hospital Department of Hematology, İstanbul, Turkey
| | - Cem Kis
- Adana Baskent University Faculty of Medicine Department of Hematology, Adana, Turkey
| | - Zeynep Tuğba Güven
- Erciyes University Faculty of Medicine Department of Hematology, Kayseri, Turkey
| | - Aydan Akdeniz
- Mersin University Faculty of Medicine Department of Hematology, Mersin, Turkey
| | - Tiraje Celkan
- İstinye University Faculty of Medicine Department of Pediatric Hematology, İstanbul, Turkey
| | | | | | - Ceyda Özçelik Şengöz
- Karadeniz Technical University Faculty of Medicine Department of Hematology, Trabzon, Turkey
| | - Ayse Karataş
- Hacettepe University Faculty of Medicine Department of Hematology, Ankara, Turkey
| | - Tuba Bulduk
- Health Sciences University Gulhane Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Alper Özcan
- Erciyes University Faculty of Medicine Department of Pediatric Hematology, Kayseri, Turkey
| | - Fatma Burcu Belen Apak
- Ankara Başkent University Faculty of Medicine Department of Pediatric Hematology, Ankara, Turkey
| | - Aylin Canbolat
- İstanbul Medeniyet University Faculty of Medicine Department of Pediatric Hematology, İstanbul, Turkey
| | - İbrahim Kartal
- Ondokuz Mayıs University Faculty of Medicine Department of Pediatric Hematology, Samsun, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine Department of Pediatric Hematology, İzmir, Turkey
| | - Ersin Töret
- Eskişehir Osmangazi University Faculty of Medicine Department of Pediatric Hematology, Eskişehir, Turkey
| | - Gül Nihal Özdemir
- İstinye University Faculty of Medicine Department of Pediatric Hematology, İstanbul, Turkey
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12
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Bracale U, Di Nuzzo MM, Bracale UM, Del Guercio L, Panagrosso M, Serra R, Terracciano RM, De Werra C, Corcione F, Peltrini R, Sodo M. Sequential Minimally Invasive Treatment of Concomitant Abdominal Aortic Aneurysm and Colorectal Cancer: A Single-Center Experience. Ann Vasc Surg 2021; 78:226-232. [PMID: 34492315 DOI: 10.1016/j.avsg.2021.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/03/2021] [Accepted: 07/06/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND The surgical management of concomitant occurrence of abdominal aortic aneurysm (AAA) and colorectal cancer (CRC) is still controversial. Conversely, benefits from a minimally invasive approach are well known concerning the treatment of both AAA and CRC. The aim of this study is to assess safety and feasibility of a sequential 2-staged minimally invasive during the same recovery by endovascular aneurysm repair (EVAR) technique and laparoscopic colorectal resection. METHODS From January 2008 to December 2020, all patients with concomitant AAA and CRC were consecutively treated by EVAR and laparoscopic colorectal resection. Perioperative data were retrospectively collected in order to evaluate short- and long-term outcomes following the sequential 2-staged procedures. RESULTS A total of 24 patients were included. The localization of the aneurysm was infrarenal abdominal aortic in 23 cases and in one case of common iliac artery. EVAR procedure has always been performed first. In 18 patients, a percutaneous access has been used while in 6 patients a surgical access has been adopted. Twelve patients had cancer in the left colon, 9 in the right colon, and 3 patients had rectal cancer. No conversions or intraoperative complications had occurred during laparoscopic surgery. The major complications rate after EVAR and CRC surgery was 8.3% and 12.5%, respectively. The mean interval between EVAR and CRC treatment was 7.8 ± 1 and the mean length of stay was 15.4 ± 3.6. No deaths occurred during hospitalization and between the procedures. Overall mortality was 20.8% with a mean follow-up of 39.41 ± 19.2 months. CONCLUSION Elective sequential 2-staged minimally invasive treatment is a safe and feasible approach with acceptable morbidity and mortality rates and it should be adopted in current clinical practice to manage concomitant AAA and CRC.
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Affiliation(s)
- Umberto Bracale
- Department of Public Health, Minimally Invasive General and Oncological Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Maria Michela Di Nuzzo
- Department of Public Health, Minimally Invasive General and Oncological Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Umberto Marcello Bracale
- Department of Public Health, Vascular Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Luca Del Guercio
- Department of Public Health, Vascular Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Marco Panagrosso
- Department of Public Health, Vascular Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Raffaele Serra
- Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy
| | - Rosa Maria Terracciano
- Department of Public Health, Minimally Invasive General and Oncological Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Carlo De Werra
- Department of Public Health, Minimally Invasive General and Oncological Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Francesco Corcione
- Department of Public Health, Minimally Invasive General and Oncological Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Roberto Peltrini
- Department of Public Health, Minimally Invasive General and Oncological Surgery Unit, University of Naples Federico II, Naples, Italy.
| | - Maurizio Sodo
- Department of Public Health, Minimally Invasive General and Oncological Surgery Unit, University of Naples Federico II, Naples, Italy
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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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14
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Serpa Carmoma F, Cueva M, Serpa Carmoma F, Molina GA, Yu Lee A, Flores E. Castleman's disease: Laparoscopic resection of unicentric disease in the hepatic hilum: A case report. Ann Med Surg (Lond) 2021; 67:102494. [PMID: 34188910 PMCID: PMC8219645 DOI: 10.1016/j.amsu.2021.102494] [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: 04/28/2021] [Revised: 06/02/2021] [Accepted: 06/05/2021] [Indexed: 02/07/2023] Open
Abstract
Introduction and importance Castleman's disease was first reported by Benjamin Castleman et al., in 1954 and described it as a sporadic lymphoproliferative disorder. The pathophysiology to this day is still unknown, although IL-6 is suspected to play an important role. Preoperative diagnosis is challenging due to its non-specific symptoms, and that imaging cannot clearly distinguish the disease from other processes. High clinical awareness is necessary to reach a diagnosis. If the disease is localized, complete recovery can be achieved through surgery. Case presentation Patient is a 68-year-old woman with a three-month history of recurrent episodes of fever, myalgias, and night sweats. She started to experience lower abdominal pain and presented to the emergency room. A contrast-enhanced abdominal computed tomography revealed a 5 cm well-circumscribed focal heterogeneously enhancing hyperplastic mass between the portal vein and the inferior vena cava. After successful laparoscopic surgery, the mass was resected, and the patient fully recovered. Unicentric Castleman's disease was the final diagnosis. Discussion and conclusion Castleman's disease is an uncommon pathology with a challenging diagnosis. When approaching an abdominal mass, unicentric Castleman's disease should always be a differential diagnosis, as treatment can be curative with surgical resection. With the advent of laparoscopic and robotic surgery, these techniques can improve patients' outcomes in these rare pathologies, especially when they appear in complex regions. Castleman's disease is an uncommon pathology with a challenging diagnosis. Abdominal Unicentric Castleman's disease must be considered when approaching a patient with an abdominal mass. Surgery is the most effective treatment for Unicentric Castleman's disease, and with laparoscopy, better results are expected.
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Affiliation(s)
| | - Marta Cueva
- Hospital Metropolitano Department of General Surgery, Quito, Ecuador
| | | | - Gabriel A Molina
- Hospital Metropolitano Department of General Surgery, Quito, Ecuador.,Universidad San Francisco de Quito (USFQ), Quito, Ecuador
| | | | - Emilia Flores
- Universidad San Francisco de Quito (USFQ), Quito, Ecuador
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15
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Castleman disease: A single-center case series. Int J Surg Case Rep 2021; 80:105650. [PMID: 33631648 PMCID: PMC7907481 DOI: 10.1016/j.ijscr.2021.105650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 01/11/2023] Open
Abstract
Castleman disease is an overgrowth of lymphatic cells, usually in the chest or abdomen. Multicentric Castleman disease affects lymphatic cells throughout the body. HHV-8 and HIV have been associated with multicentric Castleman disease. Unicentric Castleman disease affects a single group of lymph nodes. Centricity is considered the most important indicator of patient outcomes.
Background Castleman disease (CD) is a rare lymphocytic disorder. Unicentric CD (UCD) has an excellent long-term prognosis after surgical excision; however, multicentric CD (MCD) has a severe clinical course with poor outcomes. Study design We analyzed the clinical presentation of 28 patients treated at a single institution from 1995 to 2017. Demographics, clinical variables, anatomical site, centricity, histopathology, immunochemistry, and surgical approach were reviewed. We evaluated the 5-year recurrence and survival for patients with UCD and MCD. Results Of the 28 patients, 57 % (n = 16) were female, with a mean age of 41.6 ± 15.6 years. CD was asymptomatic in 57 % (n = 16) of patients, 21 % (n = 6) presented with local symptoms such as pain, and 21 % (n = 6) of patients also had systemic symptoms, including weight loss and fever. CD was unicentric in 64 % (n = 18) and multicentric in 36 % (n = 10). The hyaline vascular variant was noted in 57 % (n = 16) of the tumors, plasmacytoid variant in 36 % (n = 10), and mixed variants in 7% (n = 2) of tumors. Anatomical distributions included: head and neck (20 %), thorax and axilla (24 %), retroperitoneal (13 %), abdominopelvic (30 %) regions, and other (13 %). Complete surgical resection was performed in 95 % of patients with UCD. Surgical biopsy and medical therapy were provided to all patients with MCD. The recurrence rate for UCD and MCD was 6 % (n = 1) and 14 % (n = 1), respectively. The five-year disease-free survival rate for UCD was 95 % (n = 19) and MCD was 33 % (n = 2). We found 100 % survival in patients with UCD and histology demonstrating the HV variant. Conclusion CD is rare and often misdiagnosed due to the absence of specific clinical symptoms. Surgeons should include CD in their differential diagnoses when evaluating patients with lymph node hyperplasia. Surgery can be curative in nearly all patients with UCD. Patients with MCD require a combination of surgical therapy, chemotherapy, and immunotherapy; however, cytoreductive surgery benefits for patients with MCD have not been established.
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Kitakaze M, Miyoshi N, Fujino S, Ogino T, Takahashi H, Uemura M, Mizushima T, Doki Y, Eguchi H. Surgical resection for pelvic retroperitoneal Castleman's disease: A case report and review literature. Biomed Rep 2021; 14:29. [PMID: 33520228 PMCID: PMC7841734 DOI: 10.3892/br.2021.1405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/30/2020] [Indexed: 12/27/2022] Open
Abstract
Castleman's disease (CD) is a rare atypical lymphoproliferation disorder first reported in 1954. Clinically, CD is classified as unicentric or multicentric CD based on anatomical distribution. Unicentric CD primarily affects the mediastinum, and rarely affects the retroperitoneal location. The standard treatment for unicentric CD is complete surgical resection; however, this can be complicated by a high degree of attachment with other organs or hypervascularity. Preoperative angiography and embolization of the arteries that feed the problematic mass can reduce intraoperative bleeding in cases of CD with hypervascularity. In the present case report, a 44-year-old man who was found to have a pelvic retroperitoneal mass with calcification based on abdominal imaging results is discussed. Due to the hypervascularity of the mass, preoperative embolization was performed. The mass was completely resected without any complications. Additionally, a review of the literature on pelvic CD and preoperative embolization of CD was performed to provide an up-to-date reference on the management and outcomes of patients with CD.
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Affiliation(s)
- Masatoshi Kitakaze
- Department of Gastroenterological Surgery, Osaka University, Osaka 5650871, Japan
| | - Norikatsu Miyoshi
- Department of Gastroenterological Surgery, Osaka University, Osaka 5650871, Japan
| | - Shiki Fujino
- Department of Gastroenterological Surgery, Osaka University, Osaka 5650871, Japan
| | - Takayuki Ogino
- Department of Gastroenterological Surgery, Osaka University, Osaka 5650871, Japan
| | - Hidekazu Takahashi
- Department of Gastroenterological Surgery, Osaka University, Osaka 5650871, Japan
| | - Mamoru Uemura
- Department of Gastroenterological Surgery, Osaka University, Osaka 5650871, Japan
| | - Tsunekazu Mizushima
- Department of Gastroenterological Surgery, Osaka University, Osaka 5650871, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Osaka University, Osaka 5650871, Japan
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Osaka University, Osaka 5650871, Japan
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Bracale U, Pontecorvi E, Silvestri V, Cuccurullo D, D'Ambra M, Lionetti R, Coppola A, Carannante F, Pirozzi F, Peltrini R, Sciuto A, Corcione F. Laparoscopic segmental resection for tumours of the Angle of Treitz: a challenging but feasible surgical option. Results from a retrospective case-series analysis. Updates Surg 2020; 73:179-186. [PMID: 33146889 PMCID: PMC7889543 DOI: 10.1007/s13304-020-00910-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 10/24/2020] [Indexed: 12/22/2022]
Abstract
Tumours of the small intestine are rare and account for about 5% of gastrointestinal tract neoplasms. The angle of Treitz (AT) could be defined as the intestinal loop comprised between the third duodenal portion and the first 10 cm of jejunum. A gold standard surgical treatment for AT neoplasm has not yet been well defined. This paper is focused on a very rare disease and at the best of our knowledge this is the largest case series in the literature about the Laparoscopic Segmental Resection (LSR) of AT tumours. Using a prospectively collected database, all data of consecutive patients, from January 2007 to May 2019, who underwent LSR for AT tumours at two different institutions were analysed. Patients’ demographics, intra and post-operative data, 30-day mortality and overall survival were collected. A total of 16 patients were retrieved from our database. The mean operative time was 206,5 ± 79 min. Conversion to open surgery was needed in two cases due to tumor size and, respectively, invasion of the transverse colon which required a multivisceral resection. The mean distal and proximal resection margins were 7.4 ± 2.2 and 3.9 ± 1.2 cm. The median number of harvested nodes was 9 ± 3. Pathological diagnosis was GIST in 11 cases, adenocarcinoma in 4 and sarcoma in 1 case. In conclusion, in experienced hands, LSR appears to be a safe and effective treatment option for tumours of the AT. Prospective studies are needed to confirm these findings.
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Affiliation(s)
- Umberto Bracale
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Via Pansini 5 7th Building, Naples, Italy.
| | - Emanuele Pontecorvi
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Via Pansini 5 7th Building, Naples, Italy
| | - Vania Silvestri
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Via Pansini 5 7th Building, Naples, Italy
| | - Diego Cuccurullo
- Department of General Surgery, Azienda Ospedaliera Dei Colli, Monaldi Hospital, Naples, Italy
| | - Michele D'Ambra
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Via Pansini 5 7th Building, Naples, Italy
| | - Ruggero Lionetti
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Via Pansini 5 7th Building, Naples, Italy
| | - Andrea Coppola
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Via Pansini 5 7th Building, Naples, Italy
| | - Filippo Carannante
- Department of Geriatric Surgery, Università Campus Bio-Medico, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - Felice Pirozzi
- Department of General Surgery, Santa Maria delle Grazie Hospital, Pozzuoli, Italy
| | - Roberto Peltrini
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Via Pansini 5 7th Building, Naples, Italy
| | - Antonio Sciuto
- Department of General Surgery, Santa Maria delle Grazie Hospital, Pozzuoli, Italy
| | - Francesco Corcione
- Department of General and Oncological Minimally Invasive Surgery, University Federico II of Naples, Via Pansini 5 7th Building, Naples, Italy
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Hu C, Zou Y, Pan J, Yang J, Yang T, Tan T, Li J. Analysis of Clinical Characteristics, Pathological Changes and Changes of Interleukin-6 (IL-6) and C-Reactive Protein (CRP) in Children with Castleman's Disease. Med Sci Monit 2020; 26:e924783. [PMID: 32873770 PMCID: PMC7446284 DOI: 10.12659/msm.924783] [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] [Indexed: 11/12/2022] Open
Abstract
Background The aim of this study was to analyze the pathological changes, clinical characteristics and changes in immunity, interleukin-6 (IL-6) and C-reactive protein (CRP) in children with Castleman’s disease (CD). Material/Methods A total of 15 CD child patients were enrolled as observation group, while 20 normal children receiving healthy examination were enrolled as healthy control group. The pathological changes, clinical characteristics and changes in immunity and serum IL-6 and CRP expressions were retrospectively analyzed in observation group. Results The clinical manifestation of unicentric CD (UCD) was mainly enlargement of cervical lymph nodes without liver-spleen enlargement and fever, and the major pathological type was the hyaline-vascular type. Multicentric CD (MCD) child patients all had anemia, fever and other systemic symptoms, and the major pathological type was the plasma-cell type. There were expressions of the immune indexes, including cluster of differentiation 3 (CD3), CD4, CD8, CD20, and CD79, in a certain degree, while CD138 and VS38C expressions displayed the polyclonal proliferation of plasma cells, rather than neoplastic proliferation. The Epstein-Barr virus and human herpes virus-8 detection results were negative, and CD21 in follicular dendritic cells in abnormal germinal center was positive. The expression levels of serum IL-6 and CRP in observation group were higher than those in control group (P<0.05). Conclusions There are immune dysfunction and increased expressions of serum IL-6 and CRP in child patients with CD, so it can be speculated that the immune abnormality and overexpression of serum inflammatory factors may be associated with the occurrence of CD.
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Affiliation(s)
- Chao Hu
- Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Yan Zou
- Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Jing Pan
- Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Jiliang Yang
- Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Tianyou Yang
- Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Tianbao Tan
- Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Jiahao Li
- Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
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19
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Zhang J, Wang J, Liu B, Wang Q. Upper left abdominal pain in young female patient. J Am Coll Emerg Physicians Open 2020; 1:298-299. [PMID: 33000050 PMCID: PMC7493490 DOI: 10.1002/emp2.12044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/15/2020] [Accepted: 02/19/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jiawei Zhang
- Department of Emergency Medicine The First Hospital of Jilin University Changchun Jilin China
| | - Jing Wang
- Department of Orthopedics The First Hospital of Jilin University Changchun Jilin China
| | - Baohua Liu
- Department of Emergency Medicine The First Hospital of Jilin University Changchun Jilin China
| | - Qi Wang
- Radiological Department The First Hospital of Jilin University Changchun Jilin China
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Lv K, Zhao Y, Xu W, Zhang C, Huang P. Ultrasound and radiological features of abdominal unicentric castleman's disease: A case series study. Medicine (Baltimore) 2020; 99:e20102. [PMID: 32358399 PMCID: PMC7440244 DOI: 10.1097/md.0000000000020102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aimed to improve the diagnostic accuracy of abdominal unicentric Castleman's disease (UCD) by retrospectively summarizes the relatively specific imaging features of UCD.This study retrospectively collected fifteen patients with abdominal UCD confirmed by pathology. All patients were underwent ultrasound (US), computed tomography (CT), or magnetic resonance imaging (MRI) examination. The imaging findings of UCDs were analyzed by senior radiologists.Fifteen patients included 7 males and 8 females, aged 30 to 68 years old, with an average age of 51.73 ± 13.57. In the 15 cases, 7 were located around the mesentery, 4 were located in the retroperitoneal space, and 4 in the liver. Fifteen cases contained solid masses, of which 13 had clear margins and 2 had blurred margins. The size of the mass ranged from 1.5 to 14.2 cm, with an average of 6.49 ± 4.16 cm. US showed that 9 lesions were presented with hypo-echogenicity while 5 lesions presented with hyper-echogenicity spots. Unenhanced CT showed that the lesions were comprised of soft tissue while calcified lesions were found in 10 of the cases (66.67%, 10/15). T1-weighted imaging (T1WI) suggested the lesions as iso/hypo-signal, and mildly hyper-signal on T2-weighted imaging (T2WI). Diffusion-weighted imaging (DWI) showed different degrees of hyper-signal. Contrast-enhanced US and CT/MRI showed obvious enhancement at the arterial phase in 12 cases (85.71%, 12/14), most of which (50%, 7/14) showed continuous enhancement at the delayed phase. Feeding vessel could be seen within, or around the lesion in 5 cases (35.71%, 5/14).The study suggests that abdominal UCD commonly manifests as well-defined, homogeneous, solid, and hypervascular masses. Calcification and the presence of feeding vessel in the tumors are relatively specific features of abdominal UCD.
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Imen BI, Zenaidi H, Abdelwahed Y, Sabeur R, Ayoub Z. Management of isolated retroperitoneal Castelman's disease: A case report. Int J Surg Case Rep 2020; 70:24-27. [PMID: 32361607 PMCID: PMC7200444 DOI: 10.1016/j.ijscr.2020.03.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/14/2020] [Accepted: 03/27/2020] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Castleman's disease (CD) is a rare disorder characterized by benign angio follicular lymphoid hyperplasia, with gentle behavior. Its etiology and prevalence are unclear. It is usually found in the mediastinal area and it is rare to see this tumor in the retroperitoneum. PRESENTATION OF CASE A 53 year old male with a retroperitoneal hypervascular calcified mass densely adherent to the psoas muscle that was accidentally encountered on a CT scan. Provisional diagnosis of retroperitoneal liposarcoma was made and the patient underwent an exploratory laparotomy. The histologic examination of the surgically resected specimen disclosed « a hyaline type of Castleman's disease ». DISCUSSION Castleman's disease, is a rare heterogenous group of lymphoproliferative disorders that arises mostly in the mediastinum. The retroperitoneal localization is very rare. Clinically, CD can be subdivided into a localized form (unicentric disease) and a generalized form (multicentric disease) according to the number of lymph nodes involved. A careful histological and immunohistochemical examination of the tumor tissue after surgery is the only way for tumor diagnosis. CONCLUSION Castelman's disease is a rare entity that has often benign and non invasive behavior, but remains a diagnostic challenge. There is no reliable diagnostic method and its definitive diagnosis is based on histopathology report. For treating the unicentric variant, radical surgical resection is considered to be the gold standard.
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Affiliation(s)
- Ben Ismail Imen
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia.
| | - Hakim Zenaidi
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia.
| | - Yahmadi Abdelwahed
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia.
| | - Rebii Sabeur
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia.
| | - Zoghlami Ayoub
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia.
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Sawaya Z, Semaan DB, Nicolas G, Dib A, Tayar C. Unicentric Castleman's Disease: Laparoscopic Approach of a Para-Duodenal Retroperitoneal Mass. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e918444. [PMID: 32245939 PMCID: PMC7942204 DOI: 10.12659/ajcr.918444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Castleman's disease is a benign, lymphoproliferative disorder that is extremely uncommon. Multiple classifications have been described; however, the exact etiology remains unknown. Preoperative diagnosis is not common, as imaging cannot distinguish the disease from other processes, and biopsy is insufficient to provide the architecture of the mass, which is necessary for diagnosis. Unicentric retroperitoneal disease has been described, and management includes complete resection of the mass, which is usually curative. CASE REPORT A 34-year-old previously healthy woman presented with hematuria. Evaluation revelated a retroperitoneal mass that was abutting the duodenum and head of the pancreas. Biopsy failed to provide a diagnosis, so laparoscopic resection was performed. Postoperative diagnosis was consistent with unicentric Castleman's disease. CONCLUSIONS Castleman's disease is an uncommon process, and one that is difficult to diagnose. Unicentric Castleman's disease should always be a differential diagnosis of solitary retroperitoneal masses that are well-demarcated, as treatment can be curative with surgical resection.
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Affiliation(s)
- Zeina Sawaya
- Department of Surgery, Clemenceau Medical Center, Beirut, Lebanon
| | - Dana B Semaan
- Department of Surgery, Clemenceau Medical Center, Beirut, Lebanon
| | - Gregory Nicolas
- Department of Surgery, Clemenceau Medical Center, Beirut, Lebanon
| | - Abbas Dib
- Department of General Surgery, Clemenceau Medical Center, Beirut, Lebanon
| | - Claude Tayar
- Department of General Surgery, Clemenceau Medical Center, Beirut, Lebanon
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Huang Z, Jin T, Zhang X, Wu Z. Pancreatic mass found to be Castleman disease, a rare case report. Asian J Surg 2020; 43:767-768. [PMID: 32171606 DOI: 10.1016/j.asjsur.2020.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 12/20/2022] Open
Affiliation(s)
- Zhengbin Huang
- Department of General Surgery, Hanchuan People's Hospital, 1 Renmin Avenue, Hanchuan, Hubei, 431600, China
| | - Tian Jin
- Department of Pathology, Hanchuan People's Hospital, 1 Renmin Avenue, Hanchuan, Hubei, 431600, China
| | - Xiongjie Zhang
- Department of General Surgery, Hanchuan People's Hospital, 1 Renmin Avenue, Hanchuan, Hubei, 431600, China
| | - Zhengqi Wu
- Winchester Medical center, Department of Medicine, 1840 Amherst Street, Winchester, VA, 22601, USA.
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24
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Hamilton JM, Al Khdhur H, Mitchell C, Warrier SK, Heriot AG. Laparoscopic high anterior resection for unicentric Castleman's disease of the sigmoid mesocolon. ANZ J Surg 2020; 90:2137-2138. [PMID: 32115836 DOI: 10.1111/ans.15792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 02/15/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Jordan M Hamilton
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Hussain Al Khdhur
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Catherine Mitchell
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Satish K Warrier
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Alexander G Heriot
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
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25
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De Placido S, Bracale U, Pacelli R, Sodo M, Merola G, Silvestri V, Corcione F. A New Strategy for a High Tumour Burden Region: The Campania Oncological Network. Transl Med UniSa 2020; 21:59-60. [PMID: 32123684 PMCID: PMC7039273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S De Placido
- University Hospital School of Medicine Federico II of Naples, Department of Clinical Medicine and Surgery
| | - U Bracale
- University Hospital School of Medicine Federico II of Naples, Department of Gastroenterology, Endocrinology and Surgical Endoscopy
| | - R Pacelli
- University Hospital School of Medicine Federico II of Naples, Department of Advanced Biomedical Sciences
| | - M Sodo
- University Hospital School of Medicine Federico II of Naples, Vascular and Endovascular Surgery Unit, Department of Public Health
| | - G Merola
- University Hospital School of Medicine Federico II of Naples, Department of Gastroenterology, Endocrinology and Surgical Endoscopy
| | - V Silvestri
- University Hospital School of Medicine Federico II of Naples, Department of Gastroenterology, Endocrinology and Surgical Endoscopy
| | - F Corcione
- University Hospital School of Medicine Federico II of Naples, Department of Gastroenterology, Endocrinology and Surgical Endoscopy
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26
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Bracale U, Merola G, Pignata G, Corcione F, Pirozzi F, Cuccurullo D, De Palma GD, Cassinotti E, Sciuto A, Boni L. Laparoscopic resection with complete mesocolic excision for splenic flexure cancer: long-term follow-up data from a multicenter retrospective study. Surg Endosc 2019; 34:2954-2962. [PMID: 31451917 DOI: 10.1007/s00464-019-07078-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/19/2019] [Indexed: 12/19/2022]
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27
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Haap M, Wiefels J, Horger M, Hoyer A, Müssig K. Clinical, laboratory and imaging findings in Castleman's disease - The subtype decides. Blood Rev 2018; 32:225-234. [PMID: 29223447 DOI: 10.1016/j.blre.2017.11.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 11/21/2017] [Accepted: 11/28/2017] [Indexed: 01/09/2023]
Abstract
Castleman's disease (CD) is a rare lymphoproliferative disorder with its distinct unicentric (uCD) and multicentric (mCD) entities. The present work aimed at characterizing CD in more detail. From the 775 articles found by a PubMed search, 1133 cases were extracted. Two own cases were included. UCD was identified in 719 (42% males) and mCD in 416 (63% males) cases. Age in uCD was 34±17 and in mCD 48±18years. The hyaline-vascular type predominated in uCD and the plasma cell type in mCD. Clinical symptoms were more common in mCD. The head and neck region was most frequently affected in uCD and the axillary region in mCD. Prevalence of human immunodeficiency virus (HIV) and human herpesvirus-8 (HHV-8) positivity was higher in mCD. In CT scans, high contrast enhancement and calcifications were more frequent in uCD (all p<0.0001). The two forms of CD not only differ markedly in their clinical, laboratory and imaging findings, but also in treatment response and prognosis.
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Affiliation(s)
- Michael Haap
- Department of Internal Medicine, Medical Intensive Care Unit, University of Tübingen, Tübingen, Germany; Department of Internal Medicine, Endocrinology und Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Tübingen, Germany
| | - Julia Wiefels
- Department of Internal Medicine, Endocrinology und Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Tübingen, Germany
| | - Marius Horger
- Department of Radiology, University of Tübingen, Tübingen, Germany
| | - Annika Hoyer
- Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Center of Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), München, Neuherberg, Germany
| | - Karsten Müssig
- German Center for Diabetes Research (DZD), München, Neuherberg, Germany; Divison of Endocrinology und Diabetology, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
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28
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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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29
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Sbrana F, Zhou D, Zamfirova I, Leonardi N. Castleman's disease: a rare presentation in a retroperitoneal accessory spleen, treated with a minimally invasive robotic approach. J Surg Case Rep 2017; 2017:rjx195. [PMID: 29026518 PMCID: PMC5633649 DOI: 10.1093/jscr/rjx195] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/19/2017] [Indexed: 01/02/2023] Open
Abstract
Unicentric Castleman’s disease (UCD) is a rare disorder of unknown etiology characterized by localized lymphoid tissue proliferation and interfollicular hypervascularity. A 33-year-old Caucasian female presented with vague abdominal discomfort and pain with pressure. Ultrasound and computed tomography detected a large peripancreatic mass. Robotic-assisted resection of the mass along with en bloc dissection of the encased left adrenal gland was done. Frozen section examination confirmed UCD hyaline vascular variant in a retroperitoneal accessory spleen. Preoperative diagnosis of UCD is difficult due to its lack of specific symptoms and its cytologic similarity to reactive lymphadenopathy and other lymphoproliferative disorders. Surgical resection is standard treatment and provides the pathological specimen required for diagnostic confirmation. Here, robotic-assisted laparoscopy allowed visualization, mobilization, precise resection and extraction of the mass from a difficult to access retroperitoneal region.
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Affiliation(s)
- Fabio Sbrana
- Department of Surgery, Advocate Lutheran General Hospital, Park Ridge, IL 60068, USA
| | - Dimin Zhou
- Chicago Medical School, Rosalind Franklin University, North Chicago, IL 60064, USA
| | - Ina Zamfirova
- James R. & Helen D. Russell Institute for Research & Innovation, Advocate Lutheran General Hospital, Park Ridge, IL 60068, USA
| | - Nathaniel Leonardi
- James R. & Helen D. Russell Institute for Research & Innovation, Advocate Lutheran General Hospital, Park Ridge, IL 60068, USA
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30
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Xie Y, Zhao Y, Ji ZG, Li HZ, Liu GH, Mao QZ. Castleman's Disease: A Rare Mass in the Pararenal Retroperitoneum that Mimics Other Tumors. Chin Med J (Engl) 2017; 130:2126-2127. [PMID: 28836561 PMCID: PMC5586187 DOI: 10.4103/0366-6999.213418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Yi Xie
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Yi Zhao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Zhi-Gang Ji
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Han-Zhong Li
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Guang-Hua Liu
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Quan-Zhong Mao
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
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