The full content of Annals is available to subscribers

Subscribe/Learn More  >
Reviews |

The Clinical Behavior of Localized and Multicentric Castleman Disease

Juan Herrada, MD; Fernando Cabanillas, MD; Lawrence Rice, MD; John Manning, MD; and William Pugh, MD
[+] Article, Author, and Disclosure Information

From the University of Texas M.D. Anderson Cancer Center, Baylor College of Medicine, and Methodist Hospital, Houston, Texas. Acknowledgments: The authors thank Norman Maldonado, Shirley Riggs, David Sears, Mark Udden, Jerome Bart, Raquel Gerson, Christine Hayes, Garrett Lynch, Eugenio Banez, Jackie Abrams, and Eugenio Galindo for providing clinical information and histologic material. They also thank Claude Y. Chong for insightful comments. Requests for Reprints: Fernando Cabanillas, MD, Lymphoma Section, Department of Hematology, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030. Current Author Addresses: Dr. Herrada: El Paso Cancer Treatment Center, 7848 Gateway East, El Paso, TX 79915.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;128(8):657-662. doi:10.7326/0003-4819-128-8-199804150-00010
Text Size: A A A

Background: Castleman disease, an unusual condition of unknown cause consisting of a massive proliferation of lymphoid tissue, remains a clinicopathologic diagnosis. Three histologic variants (hyaline vascular, plasma-cell, and mixed) and two clinical types (localized and multicentric) of Castleman disease have been described.

Objective: To analyze the clinical features, management, and outcome of patients with Castleman disease.

Design: Case series.

Setting: University referral hospitals.

Patients: All patients with Castleman disease who were seen at Texas Medical Center, Houston, Texas, between 1977 and 1995.

Interventions: Surgical excision for localized disease; surgery, combination chemotherapy, or prednisone for multicentric disease.

Measurements: Patients were identified according to initial presentation as having localized or multicentric Castleman disease. Patients within each group were further subdivided according to whether they had hyaline vascular, plasma-cell, or mixed disease.

Results: Data from 15 patients were analyzed. All 7 patients with localized disease underwent surgical excision and remain free of disease. The 8 patients with multicentric disease were further subdivided according to initial treatment: Three patients who received combination chemotherapy are currently alive and free of disease; 2 patients treated with prednisone are alive but have needed intermittent maintenance therapy for disease reactivations; and 2 patients treated with surgery only have died, 1 of infectious complications and 1 of non-Hodgkin lymphoma.

Conclusions: Localized and multicentric Castleman disease are different clinical disorders with overlapping histologic features. Localized disease can be cured with surgery, but complete remissions in patients with multicentric disease have been achieved only with chemotherapy or prednisone given at the time of diagnosis.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.