Retrospective analysis of 65 Castleman diseases

Abstract

Objective To explore and clarify the clinical features and management of patients with Castleman disease. Methods The clinicopathological features and therapeutic method of 65 patients with Castleman disease admitted to our hospital continuously from 2005 to 2012 were analyzed retrospectively. The mean follow-up time for the entire series was 40(15-71) months. Results In contrast to Localized Castleman disease(LCD), Multi-centric Castleman disease (MCD) patients were relatively older and exhibit various symptoms and abnormal laboratory tests. We found 44 tumor in LCD group. LCD ones, most of which were hyaline vascular(33/42, 78.6%), were more likely originated in retroperitoneum, enterocoelia(10/44, 22.7%) or mediastinum(10/44, 22.7%). The initial treatment for LCD patients was complete surgical resection and all patients are current alive with no evidence of recurrence. MCD ones always accompanied by fever(9/23, 39.1%), anemia(9/23, 39.1%) and splenomegaly, and most of MCD patients were plasmacytic variants(14/23, 60.9%) or mixed cellular variants(5/23, 21.7%). We found 66 tumor in MCD group and they were more likely originated in neck(16/66, 24.2%) and groin area(12/66, 18.2%). Surgery combined with CHOP-like chemotherapy or CHOP-like chemotherapy alone was the mainstream treatment for MCD ones. 21 patients achieved complete remission or partial remission, and only 2 patients died of lung infection. Whether patients could tolerate long-term chemotherapy or not was an important prognostic factor. Conclusions LCD patients had no typical clinical symptoms and could be cured by surgery. Most of MCD patients always had a good prognosis after receiving CHOP-like chemotherapy. Key words: Castleman disease; Clinical feature; Treatment outcome; Prognosis