Abstract
BackgroundThorax is the common place to develop Castleman disease (CD), but there is no systemic clinical analysis for intrathoracic CD.MethodsWe conducted a retrospective analysis of 48 intrathoracic CD patients with definite pathological diagnosis who were hospitalized between 1992 and 2012 in a Chinese tertiary referral hospital.ResultsThe study included 16 cases with unicentric CD (UCD) and 32 cases with multicentric CD (MCD). UCD were younger than MCD (30.5y vs 41.6ys, P < 0.05). MCD were more symptomatic (50% vs 96.9%, P < 0.001) and sicker than UCD, including more fever, hepatomegaly and/or splenomegaly and hypoalbuminemia. All of UCD showed solitary mass in various sites and two of them were complicated by small pleural effusion. In the MCD group, their chest CT showed obvious lymphadenopathy in the hilum and/or mediastinum (100%), diffuse parenchymal lung shadows (43.75%), pleural effusion (40.6%), mass in the mediastinum (6.25%) or hilum (3.12%) and bronchiolitis obliterans (BO) (3.12%). Besides LIP-like images, multiple nodules of different size and sites, patchy, ground-glass opacities and consolidation were showed in their chest CT. Surgery were arranged for all UCD for diagnosis and treatment and all were alive. In MCD group, superficial lymph nodes biopsies (21 cases), surgery biopsy (9 cases) and CT-guided percutaneous lung biopsy (2 cases) were performed. Hyaline vascular (HV) variant were more common in the UCD group (75% vs 37.5%, P < 0.05). In MCD group, 28 cases were prescribed with chemotherapy, one refused to receive therapy and the rest three were arranged for regular follow-up. Among MCD, 18 cases was improved, 7 cases was stable, 4 cases lost follow-up and 3 cases died.ConclusionsIntrathoracic MCD was more common than UCD in our hospital. MCD was older, more symptomic and sicker than UCD. HV variant were more common in UCD. All of UCD showed mass in various intrathoracic locations and surgery resection was performed for all and all were alive. Mass, pleural effusion, BO and diffuse pulmonary shadows, including LIP-like images, multiple nodules of different size and sites, patchy, GGO and consolidations were showed in our MCD. Most of MCD cases were arranged with chemotherapy and their prognosis were worse than UCD’s.
Highlights
Thorax is the common place to develop Castleman disease (CD), but there is no systemic clinical analysis for intrathoracic CD
Human immunodeficiency virus (HIV) antibody screening test was arranged for 95 CD cases, including 42 intrathoracic cases, and all of them were negative
Hyaline vascular (HV) variant cases were more common in our unicentric CD (UCD) subgroup
Summary
Thorax is the common place to develop Castleman disease (CD), but there is no systemic clinical analysis for intrathoracic CD. Castleman disease (CD) is known as angiofollicular hyperplasia or giant lymph node hyperplasia. It can be classified as unicentric (unifocal or localized) or multicentric (multifocal or generalized) according to the lesions involved [1,2,3]. Most of this data comes from rare case reports or smaller case series Some of these included cases with the main focus of disease in the neck, supraclavicular and/or axillary nodes [6]. We describe the clinical and radiological findings, as well as the outcomes of 48 intrathoracic CD patients in a single Chinese tertiary-referral hospital
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