Castleman's disease in the rheumatological practice

Abstract

The term Castleman's disease encompasses agroup of rare lymphoproliferative diseases that show histopathological similarities in lymph node biopsy. Diagnostic criteria and aspecific ICD-10 code have been available for afew years. Case studies listed at the beginning illustrate that close cooperation between clinicians and pathologists is required to enable areliable diagnosis. For an optimal histopathological assessment, the pathologist is also dependent on the removal of acomplete lymph node. Before distinguishing apotentially fatal multicentric idiopathic Castleman's disease from the resectable unicentric form, which is important in terms of prognosis and treatment, early diagnosis presupposes that Castleman's disease is considered in the differential diagnosis. Various immune phenomena and overlaps with autoimmune diseases can increase the probability of misdiagnosis or undetected cases in the clinical routine of rheumatologists. The intention of the present overview is therefore to point out the similarities with autoimmune diseases that are relevant for differential diagnoses and to point out situations that justify areview of the previous diagnosis.