Skip to main content

Part of the book series: Rare Rheumatic Diseases ((RRD))

Abstract

Castleman’s disease (CD) is a rare and relatively unknown lymphoproliferative disorder, with benign hyperplastic lymph nodes. The disease was first reported in 1956 by Benjamin Castleman, a pathologist from the Massachusetts General Hospital (Castleman and Towne, N Engl J Med 250:1001–1005, 1954). In this first case report, Castleman described a 60-year-old male with a mediastinal mass. Histology showed lymph node hyperplasia and follicles with small, hyalinized foci. Subsequently, in 1956, he described a series of 13 cases of localized asymptomatic mediastinal masses based on lymph node hyperplasia on X-ray (Castleman et al., Cancer 9:822–830, 1956). All of the patients described in these early papers had localized disease, which is now termed unicentric Castleman’s disease (UCD). In contrast, multicentric Castleman’s disease (MCD) is a systemic disease with generalized peripheral lymphadenopathy, hepatosplenomegaly, frequent episodes of fever and night sweats. In this chapter, we will discuss the pathophysiology, epidemiology, clinical presentation, diagnostic procedures, treatment and prognosis of both forms of CD.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Castleman B, Towne VW. Case records of the Massachusetts General Hospital: Case no. 40231. N Engl J Med. 1954;250(23):1001–5.

    Article  CAS  Google Scholar 

  2. Castleman B, Iverson L, Menendez VP. Localized mediastinal lymph-node hyperplasia resembling thymoma. Cancer. 1956;9(4):822–30.

    Article  CAS  Google Scholar 

  3. Powles T, et al. The role of immune suppression and HHV-8 in the increasing incidence of HIV-associated multicentric Castleman’s disease. Ann Oncol. 2009;20(4):775–9.

    Article  CAS  Google Scholar 

  4. Herrada J, et al. The clinical behavior of localized and multicentric Castleman’s disease. Ann Intern Med. 1998;128(8):657–62.

    Article  CAS  Google Scholar 

  5. Casper C. The aetiology and management of Castleman disease at 50 years: translating pathophysiology to patient care. Br J Haematol. 2005;129(1):3–16.

    Article  Google Scholar 

  6. Dossier A, et al. Human herpesvirus 8-related Castleman disease in the absence of HIV infection. Clin Infect Dis. 2013;56(6):833–42.

    Article  CAS  Google Scholar 

  7. Robinson D, et al. Clinical epidemiology and treatment patterns of patients with multicentric Castleman disease: results from two US treatment centres. Br J Haematol. 2014;165:39.

    Article  CAS  Google Scholar 

  8. Talat N, Belgaumkar AP, Schulte K-M. Surgery in Castlemanʼs disease. Ann Surg. 2012;255(4):677–84.

    Article  Google Scholar 

  9. Bower M, et al. Clinical features and outcome in HIV-associated multicentric Castleman’s disease. J Clin Oncol. 2011;29(18):2481–6.

    Article  Google Scholar 

  10. Bowne WB, Lewis JJ, Filippa DA, Niesvizky R, Brookm AD, et al. The management of unicentric and multicentric Castleman’s disease: a report of 16 cases and a review of the literature. Cancer. 1999a;85(3):706–16.

    Article  CAS  Google Scholar 

  11. Chronowski GM, et al. Treatment of unicentric and multicentric Castleman disease and the role of radiotherapy. Cancer. 2001;92(3):670–6.

    Article  CAS  Google Scholar 

  12. Frizzera G, et al. A systemic lymphoproliferative disorder with morphologic features of Castleman’s disease: clinical findings and clinicopathologic correlations in 15 patients. J Clin Oncol. 1985;3(9):1202–16.

    Article  CAS  Google Scholar 

  13. Weisenburger DD, et al. Multicentric angiofollicular lymph node hyperplasia: a clinicopathologic study of 16 cases. Hum Pathol. 1985;16(2):162–72.

    Article  CAS  Google Scholar 

  14. Soulier BJ, et al. Kaposi’s sarcoma-associated herpesvirus-like DNA sequences in multicentric Castleman’s disease. Blood. 1995;4(4):1276–80.

    Google Scholar 

  15. Guihot A, et al. Thoracic radiographic and CT findings of multicentric Castleman disease in HIV-infected patients. J Thorac Imaging. 2006;22(2):207–11.

    Article  Google Scholar 

  16. Guihot A, et al. Pulmonary manifestations of multicentric Castleman’s disease in HIV infection: a clinical, biological and radiological study. Eur Respir J. 2005;26(1):118–25.

    Article  CAS  Google Scholar 

  17. Madan R, et al. The spectrum of Castleman’s disease: mimics, radiologic pathologic correlation and role of imaging in patient management. Eur J Radiol. 2010;81(1):123–31.

    Article  Google Scholar 

  18. Barker R, et al. FDG-PET/CT imaging in the management of HIV-associated multicentric Castleman’s disease. Eur J Nucl Med Mol Imaging. 2009;36(4):648–52.

    Article  Google Scholar 

  19. Taylor GB, Smeeton IW. Cytologic demonstration of “dysplastic” follicular dendritic cells in a case of hyaline-vascular Castleman’s disease. Diagn Cytopathol. 2000;22(4):230–4.

    Article  CAS  Google Scholar 

  20. Keller AR, Hochholzer L, Castleman B. Hyaline-vascular and plasma-cell types of giant lymph node hyperplasia of the mediastinum and other locations. Cancer. 1972;29(3):670–83.

    Article  CAS  Google Scholar 

  21. Palestro G, et al. Castleman’s disease. Adv Clin Pathol. 1999;3(1–2):11–22.

    CAS  Google Scholar 

  22. Du M, et al. KSHV infects monotypic (IgM lambda) but polyclonal naive B-cells in Castleman’s disease and associated lymphoproliferative disorders. Blood. 2001;97(7):2130–6.

    Article  CAS  Google Scholar 

  23. Dupin N, et al. HHV-8 is associated with a plasmablastic variant of Castleman disease that is linked to HHV-8-positive plasmablastic lymphoma. Blood. 2000;95(4):1406–12.

    CAS  PubMed  Google Scholar 

  24. Dargent JL, et al. Plasmablastic microlymphoma occurring in human herpesvirus 8 (HHV-8)-positive multicentric Castleman’s disease and featuring a follicular growth pattern: case report. APMIS. 2006;115(7):869–75.

    Article  Google Scholar 

  25. Fajgenbaum DC, et al. International, evidence-based consensus diagnostic criteria for HHV-8—negative/idiopathic multicentric Castleman disease. Blood. 2016;129(12):1646–58.

    Article  Google Scholar 

  26. Kawabata H, et al. Castleman-Kojima disease (TAFRO syndrome): a novel systemic inflammatory disease characterized by a constellation of symptoms, namely, thrombocytopenia, ascites (Anasarca), microcytic anemia, myelofibrosis, renal dysfunction, and organomegaly : a status report and summary of Fukushima (6 June, 2012) and Nagoya Meetings (22 September, 2012). J Clin Exp Hematop. 2013;53(1):57–61.

    Article  Google Scholar 

  27. Talat N, Schulte K-M. Castleman’s disease: systematic analysis of 416 patients from the literature. Oncologist. 2011;16(9):1316–24.

    Article  Google Scholar 

  28. Muskardin TW, Peterson BA, Molitor JA. Castleman disease and associated autoimmune disease. Curr Opin Rheumatol. 2012;24(1):76–83.

    Article  CAS  Google Scholar 

  29. González García A, Moreno Cobo MÁ, Patier de la Peña JL. Current diagnosis and treatment of Castleman’s disease. Rev Clin Esp. 2016;216(3):146–56.

    Article  Google Scholar 

  30. Chan KL, et al. Update and new approaches in the treatment of Castleman disease. J Blood Med. 2016;7:145–58.

    Article  CAS  Google Scholar 

  31. Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis Res. 2002;4(Suppl 3):S265–72.

    Article  Google Scholar 

  32. Van Rhee F, et al. Siltuximab for multicentric Castleman’s disease: a randomised, double-blind, placebo-controlled trial. Lancet Oncol. 2014;15(9):966–74.

    Article  Google Scholar 

  33. Nishimoto N, et al. Humanized anti-interleukin-6 receptor antibody treatment of multicentric Castleman disease. Blood. 2005;106(8):2627–32.

    Article  CAS  Google Scholar 

  34. Nishimoto N, Sasai M. Improvement in Castleman’s disease by humanized anti-interleukin-6 receptor antibody therapy. Blood. 2000;95(1):56–61.

    CAS  PubMed  Google Scholar 

  35. Oksenhendler E, et al. High levels of human herpesvirus 8 viral load, human interleukin-6, interleukin-10, and C reactive protein correlate with exacerbation of multicentric Castleman disease in HIV-infected patients. Blood. 2000;96(6):2069–73.

    CAS  PubMed  Google Scholar 

  36. Oksenhendler E, et al. Multicentric Castleman’s disease in HIV infection: a clinical and pathological study of 20 patients. AIDS. 1996;10(1):61–6.

    Article  CAS  Google Scholar 

  37. Scott D, Cabral L, Harrington WJ. Treatment of HIV-associated multicentric Castleman’s disease with oral etoposide. Am J Hematol. 2001;66(2):148–50.

    Article  CAS  Google Scholar 

  38. Advani R, Warnke R, Rosenberg S. Treatment of multicentric Castleman’s disease complicated by the development of non-Hodgkin’s lymphoma with high-dose chemotherapy and autologous peripheral stem-cell support. Ann Oncol. 1999;10(10):1207–9.

    Article  CAS  Google Scholar 

  39. Ganti AK, et al. Successful hematopoietic stem-cell transplantation in multicentric Castleman disease complicated by POEMS syndrome. Am J Hematol. 2005;79(3):206–10.

    Article  Google Scholar 

  40. Repetto L, et al. Aggressive angiofollicular lymph node hyperplasia (Castleman’s disease) treated with high dose melphalan and autologous bone marrow transplantation. Hematol Oncol. 1986;4(3):213–6.

    Article  CAS  Google Scholar 

  41. Oksenhendler E, et al. High incidence of Kaposi sarcoma–associated herpesvirus–related non-Hodgkin lymphoma in patients with HIV infection and multicentric Castleman disease. AIDS. 2002;99(7):2331–6.

    CAS  Google Scholar 

  42. Kedes DH, Ganem D. Rapid publication sensitivity of Kaposi’s sarcoma–associated herpesvirus replication to antiviral drugs implications for potential therapy. J Clin Invest. 1996;99(9):2082–6.

    Article  Google Scholar 

  43. Larroche C, et al. Castleman’s disease and lymphoma: report of eight cases in HIV-negative patients and literature review. Am J Hematol. 2002;69(2):119–26.

    Article  Google Scholar 

  44. Abdel-Reheim FA, et al. Coexistence of Hodgkin’s disease and giant lymph node hyperplasia of the plasma-cell type (Castleman’s disease). Arch Pathol Lab Med. 1996;120(1):91–6.

    CAS  PubMed  Google Scholar 

  45. Drut R, Larregina A. Angiofollicular lymph node transformation in Hodgkin’s lymphoma. Pediatr Pathol. 1991;11(6):903–8.

    Article  CAS  Google Scholar 

  46. Maheswaran PR, et al. Hodgkin’s disease presenting with the histological features of Castleman’s disease. Histopathology. 1991;18(3):249–53.

    Article  CAS  Google Scholar 

  47. McAloon EJ. Hodgkin’s disease in a patient with Castleman’s disease. N Engl J Med. 1985;313(12):758.

    CAS  PubMed  Google Scholar 

  48. Bélec L, Authier F-J, et al. Antibodies to human herpesvirus 8 in POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes) syndrome with multicentric Castleman’s disease. Clin Infect Dis. 1999a;26:678–9.

    Article  Google Scholar 

  49. Bélec L, Mohamed AS, et al. Human herpesvirus 8 infection in patients with POEMS syndrome—associated multicentric Castleman’s disease. Blood. 1999b;93(11):3643–53.

    PubMed  Google Scholar 

  50. Dispenzieri A. POEMS syndrome: 2017 update on diagnosis, risk stratification, and management. Am J Hematol. 2016;92(8):814–29.

    Article  Google Scholar 

  51. Kop EN, MacKenzie MA. Clinical images: Castleman disease and paraneoplastic pemphigus. CMAJ. 2010;182(1):61.

    Article  Google Scholar 

  52. Musters A, Tas SW. How to monitor safety and efficacy of biologic treatment in rare, therapy-refractory immune-mediated inflammatory diseases? Rheumatology. 2018;57(4):591–3.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anne Musters .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Musters, A., Tas, S.W. (2019). Castleman’s Disease. In: Tarrant, T. (eds) Rare Rheumatic Diseases of Immunologic Dysregulation. Rare Rheumatic Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-99139-9_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-99139-9_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99138-2

  • Online ISBN: 978-3-319-99139-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics