Unicentric Type Research Articles

Castleman's Disease: A Case Report of the Unicentric Type

Castleman's disease, or angiofollicular lymph node hyperplasia, is a relatively rare disorder characterized by the benign proliferation of lymphoid tissue related to the chronic human herpes virus 8 (HHV-8) infection and the human immunodeficiency virus (HIV). Two clinical entities have been described: a unicentric presentation with the disease confined to a single anatomic lymph node and a multicentric presentation characterized by generalized lymphadenopathy and a more aggressive clinical course. Also, three histopathological subtypes have been described: hyaline-vascular, plasma cell, and a mixed variant. Preoperative diagnosis of hyaline-vascular Castleman's disease is difficult, and the definitive result is based on postoperative pathological findings. The gold standard therapy is the complete surgical excision.

Ultrastructural Characteristics (or Evaluation) of Creutzfeldt-Jakob Disease and Other Human Transmissible Spongiform Encephalopathies or Prion Diseases

The authors report on a large series of human prion diseases to establish ultrastructural characteristics that may be useful for their diagnosis. For Creutzfeldt-Jakob disease (CJD and its variant, vCJD) and fatal familial insomnia (FFI) only vacuolation (spongiform change) and the presence of tubulovesicular structures are consistent findings. Other changes, such as the presence of myelinated vacuoles, branching cisternae, neuroaxonal dystrophy, and autophagic vacuoles, were present in different proportions in either CJD or FFI, but they are nonspecific ultrastructural findings that can also occur in other neurodegenerative conditions. The hallmark of Gerstmann-Sträussler-Scheinker disease (GSS) and vCJD is the amyloid plaque, but plaques of GSS and kuru are different than those of vCJD. Whereas the former are typical unicentric kuru type or multicentric plaques, the latter are unicentric florid plaques. Also, kuru plaques are nonneuritic, whereas GSS florid plaques are usually neuritic; however, a proportion of plaques from GSS was also found to have nonneuritic characteristics. Thus, the presence or absence of dystrophic neurites is not a discriminatory factor for GSS and vCJD. Furthermore, plaques from GSS with different mutations were also slightly different. In GSS with mutations P102L, 232T, and A117V plaques were stellate while in 1 case with 144 base-pair insertion and in GSS-A117V, round plaques were also observed, and typical primitive neuritic plaques, i.e., composed of dystrophic neurites with little or no amyloid, were found only in a P102L case from the original Austrian family. In 2 cases of sporadic CJD, the kuru stellate plaque predominated.

Neoadjuvant radiotherapy of primary irresectable unicentric Castleman's disease: a case report and review of the literature

BackgroundCastleman disease (CD) is a rare benign disorder characterised by hyperplasia of lymphoid tissue that may develop at a single site or throughout the body. The etiology of this disorder is unclear, although the histopathological presentation can be differentiated into a hyaline vascular variant, a plasma cell variant and a mixed variant. Clinically, it has been recorded that 3 manifestations of CD are characterized: a localized unicentric type, a generalized multicentric type and a mixed form. Surgery remains the main treatment for resectable unicentric CD, since removal of the large node is possible without further complications. No consensus has been reached concerning the most adequate treatment for irresectable unicentric CD.MethodsCase report of a 67 year old woman.ResultsThis report, describes the case of a 67-year-old woman with unicentric Castleman disease located in the right lower abdomen. The patient had symptoms of fatigue, dyspnoea and pain in the right lower abdomen. Computed tomography (CT)- examination revealed a tumour, which had grown to form a close relationship with the common iliac vessels and the sacral bone. A Laparotomy procedure revealed that the tumour was an irresectable mass. Neo-adjuvant radiotherapy (40 Gy) was administered in order to downsize the tumour. Six weeks later a new CT-scan revealed a major reduction of the tumour, which enabled a successful radical resection of the tumour to be performed. Histopathological analysis of the tumour showed the hyaline vascular type of CD.ConclusionsNeo-adjuvant radiotherapy should be considered in case of an irresectable unicentric CD.

Retroperitoneal Pararenal Castleman's Tumor in an Adolescent Managed Laparoscopically

Journal of EndourologyVol. 22, No. 11 Laparoscopy and Robotic SurgeryRetroperitoneal Pararenal Castleman's Tumor in an Adolescent Managed LaparoscopicallyPranjal Modi, Amit Trivedi, Rahul Gupta, and S.J. RizviPranjal ModiSearch for more papers by this author, Amit TrivediSearch for more papers by this author, Rahul GuptaSearch for more papers by this author, and S.J. RizviSearch for more papers by this authorPublished Online:2 Dec 2008https://doi.org/10.1089/end.2008.0313AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byCastleman's disease in the left paravertebral regionAsian Journal of Surgery, Vol. 9Castleman’s Disease: A Unicentric Case of Abdominal Origin and Literature Review10 May 2019 | Hellenic Journal of Surgery, Vol. 91, No. 1Detection of a unicentric type of Castleman-like mass at the site of adrenal grand: A case report and review of literatureWorld Journal of Clinical Cases, Vol. 6, No. 13Left Para-Renal Castleman Disease: Case Report19 December 2018 | Journal of Interdisciplinary Medicine, Vol. 3, No. 2Laparoscopic treatment of Castleman's disease in a patient with a history of malignant Brenner tumorTaiwanese Journal of Obstetrics and Gynecology, Vol. 55, No. 5Castleman's disease of the kidney: Sonographic findings20 June 2014 | Journal of Clinical Ultrasound, Vol. 43, No. 7 Volume 22Issue 11Nov 2008 InformationMary Ann Liebert, Inc.To cite this article:Pranjal Modi, Amit Trivedi, Rahul Gupta, and S.J. Rizvi.Retroperitoneal Pararenal Castleman's Tumor in an Adolescent Managed Laparoscopically.Journal of Endourology.Nov 2008.2451-2454.http://doi.org/10.1089/end.2008.0313Published in Volume: 22 Issue 11: December 2, 2008PDF download

Outcome and late complications of radiotherapy in patients with unicentric Castleman disease

Castleman disease is a rare lymphoproliferative disorder. Surgery is considered standard therapy for the unicentric type. However, case reports have documented favorable responses to radiotherapy. The aim of this study was to analyse the clinical outcomes of five patients with unicentric Castleman disease treated with radiotherapy between 1991 and 2005. Mediastinal lymph nodes were the most common site of disease (four patients). Three patients were treated with radiotherapy alone, two patients with surgery and radiotherapy. Patients were treated with radiotherapy doses ranging from 40 Gy to 50 Gy. The median follow-up was 12 months (range, 3–175 months). During follow-up only one patient had progressive disease and died of Castleman disease. At the time of last follow-up two patients were in complete remission, one patient in partial remission, and one patient had stable disease. One patient showed serious acute and late toxicities. At the end of radiotherapy a paraneoplastic pemphigus vulgaris occurred, and eight to 11 months after radiotherapy a stenosis of the esophagus, of the left bronchus, and of the trachea due to scars. The study shows that unicentric Castleman disease is successfully treated with radiotherapy. However, for detection of possible complications as pemphigus vulgaris or stenosis of the esophagus or trachea an accurate follow-up is necessary.