Abstract
Castleman’s disease is a nonneoplastic adenopathy, also known as angiofollicular or giant lymphnode hyperplasia. Its multicentric form presents with wide spread lymphadenopathy and systemic symptoms. POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes) is observed in 11–30 % of the patients with Castleman’s disease (Dispenzieri et al., Blood 101:2496–2506, 2003). Tuberculosis and lymphoma are the common diagnosis in patients with clinical features of weight loss, lymphadenopathy, hepatosplenomegaly and lymphocyte predominant ascites. We had a similar presentation in a young male, who was a diabetic, with clinical features suggestive of probable tuberculous infiltration of abdomen and adrenals causing addisonian features, lymphocyte predominant ascites, hepatosplenomegaly and generalized lymphadenopathy. However, a pathological diagnosis of hyaline vascular variant of Castleman’s disease was obtained on lymphnode biopsy, which propelled us into doing a skeletal survey and bonemarrow biopsy. A final diagnosis of multicentric Castleman’s disease with reactive plasmacytosis was achieved. Patient had osteosclerotic lesion in the right femur with evidence of polyneuropathy, organomegaly, endocrinopathies and skin hyperpigmentation. He has improved on chemotherapy with melphan and dexamethasone. Hyaline vascular variant of Castleman’s disease rarely presents with systemic symptoms. Follow up is essential, as they can manifest with complications like POEMS and lymphoma.
References
Dispenzieri et al (2003) POEMS syndrome: definitions and long-term outcome. Blood 101:2496–2506
Dispenzieri A (2005) POEMS syndrome. Hematology Am Soc Hematol Educ Program 2005:360–367
Cronin DM, Warnke RA (2009) Castleman disease: an update on classification and the spectrum of associated lesions. Adv Anat Pathol 16(4):236–246
Bélec L, Authier FJ, Mohamed AS, Soubrier M, Gherardi R (1999) Antibodies to human herpesvirus 8 in POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes) syndrome with multicentric Castleman’s disease. Clin Infect Dis 28(3):678–679
Watanabe O, Maruyama I, Arimura K et al (1998) Overproduction of vascular endothelial growth factor/vascular permeability factor is causative in Crow–Fukase (POEMS) syndrome. Muscle Nerve 21:1390–1397
Gherardi RK, Bélec L, Fromont G, Divine M, Malapert D, Gaulard P, Degos JD (1994) Elevated levels of interleukin-1β and IL-6 in serum and increased production of IL-1P mRNA in lymph nodes of patients with polyneuropathy, organomegaly, endocrinopathy, m protein, and skin changes (POEMS) syndrome. Blood 83(9):2587–2593
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mukta, V., Susmitha, C., Kar, R. et al. Multicentric, Hyaline Vascular Variant of Castleman’s Syndrome. Indian J Hematol Blood Transfus 30 (Suppl 1), 126–130 (2014). https://doi.org/10.1007/s12288-013-0284-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12288-013-0284-x