Abstract
Although lymph node enlargement is common in active systemic lupus erythematosus (SLE), lymph node examination is frequently ignored in the diagnosis of SLE. Clinical presentation and abnormal laboratory findings are often sufficient for SLE diagnosis, not to mention that the specific histological finding of lymph node necrosis in SLE is rarely seen, and the follicular hyperplasia is usually considered as nonspecific. However, since the late 1990s, a few cases of SLE lymphadenopathy have been reported exhibiting a Castleman’s disease (CD) morphology, which was discovered in lymph node biopsies. Here we report a similar case of SLE combined with CD in a 23-year-old girl who displayed systemic symptoms, including systemic lymphadenopathy and abnormal laboratory findings indicating the active phase of SLE. A biopsy of neck lymphnodes showed histopathological features of CD. The patient responded very well to the prednisolone treatment. Based on the related literature review, we would like to stress the possibility of CD in patients with SLE lymphadenopathy.
References
Kojima M, Motoori T, Asano S et al (2007) Histological diversity of reactive and atypical proliferative lymph node lesions in systemic lupus erythematosus patients. Pathol Res Pract 203:423–431
Gohlke F, Marker-Hermann E, Kanzler S et al (1997) Autoimmune findings resembling connective tissue disease in a patient with Castleman’s disease. Clin Rheumatol 16:87–92
Simko R, Nagy K, Lombay B et al (2000) Multiventric castleman disease and systemic lupus erythematosus phenotype in a boy with Klinefelter syndrome: long-term disease stabilization with interferon therapy. J Hediatr Oncol 22:180–183
Kojima M, Nakamura S, Itoh H et al (1997) Systemic lupus erythematosus lymphadenopathy presenting with histopathologic features of Castleman’ disease: a clinicopathologic study of five cases. Pathol Res Pract 193:565–571
Herrada J, Cabanillas F, Rice L et al (1998) The clinical behavior of localized and multicentric Castleman disease. Ann Intern Med 128:657–662
Bowne WB, Lewis JJ, Filippa DA et al (1999) The management of unicentric and multicentric Castleman’s disease: a report of 16 cases and a review of the literature. Cancer 85:706–717
Frizzera G, Peterson BA, Bayrd ED et al (1985) A systemic lymphoproliferative disorder with morphologic features of Castleman’s disease. Clinical findings and clinicopathological correlations in 15 patients. J Clin Oncol 3:1202–1216
Kojima M, Matsuda H, Ijjima M et al (2005) Reactive hyperplasia with giant follicles in lymph node lesions from systemic lupus erythematosus patients, report of three cases. APMIS 113:558–563
Kojima M, Nakamura S, Oyma T et al (2001) Autoimmune disease associated lymphadenopathy with histologic appearance of T-zone dysplasia with hyperplastic follicles, a clinicopathologic analysis of nine cases. Pathol Res Pract 197:237–244
Koo CH, Nathwani BN, Winberg CD et al (1984) Atypical lymphoplasmacytic and immunoblastic proliferation in lymph nodes of patients with autoimmune disease (autoimmune-disease-associated lymphadenopathy). Medicine (Baltimore) 63:274–290
Hrycek A, Olszanecka-Gliniaowicz M, Wanat-Wisniewska M (2006) Case report of patient with systemic lupus erythematosus proceed with lymphadenopathy. Pol Arch Med Wewn 116:771–776
Cobzeanu MD, Rusu D, Negru D et al (2005) Castleman disease of the neck. Rev Med Chir Soc Med Nat Iasi 109:567–572
Mallik MK, Kapila K, Das DK et al (2007) Cytomorphology of hyaline-vascular Castleman’s disease: a diagnostic challenge. Cytopathology 18:168–174
Greiner T, Armitage JO, Gross TG (2000) Atypical lymphoproliferative diseases. Hematology Am Soc Hematol Educ Program 1:133–146
Pham TT, Harrell JH, Herndier B et al (2007) Endotracheal Castleman disease: a case report. Chest 131:590–592
Acknowledgments
This project was supported by Youth Talent Special Fund of the Health Bureau of Zhejiang Province, China (2008QN016) and ‘New Star Program’ of Zhejiang University to F. Xu.
Author information
Authors and Affiliations
Corresponding author
Additional information
Dr. Jing-yan Xia and Dr. Xi-yuan Chen equally contribute to this manuscript.
Rights and permissions
About this article
Cite this article
Xia, Jy., Chen, Xy., Xu, F. et al. A case report of systemic lupus erythematosus combined with Castleman’s disease and literature review. Rheumatol Int 32, 2189–2193 (2012). https://doi.org/10.1007/s00296-010-1451-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-010-1451-0