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Castleman’s Disease

Castleman’s Disease. Angela Dispenzieri, M.D. Mayo Clinic April 26, 2007. Scottsdale, Arizona. Rochester, Minnesota. Jacksonville, Florida. CD: Outline. History Histology Pathogenesis Clinical aspects Treatment Future directions.

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Castleman’s Disease

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  1. Castleman’s Disease Angela Dispenzieri, M.D. Mayo Clinic April 26, 2007 Scottsdale, Arizona Rochester, Minnesota Jacksonville, Florida

  2. CD: Outline • History • Histology • Pathogenesis • Clinical aspects • Treatment • Future directions

  3. Localized Mediastinal Lymph-Node Hyperplasia Resembling ThymomaCastleman, Iverson, Menendez. Cancer 9:822-30; 1956 • “A series of 13 cases of mediastinal masses resembling thymoma grossly & microscopically are shown to be a peculiar form of lymph-node hyperplasia characterized bygerminal-center formation and marked capillary proliferation.” • “Evidence is presented that the condition is neither neoplastic nor thymic in origin.”

  4. Castleman DiseaseNomenclature • Angiofollicular Lymph Node Hyperplasia (AFLNH) • Giant lymph node hyperplasia • Angiomatous lymphoid hamartoma • Benign giant lymphoma • Follicular lympho-reticuloma

  5. Castleman's description1,2 PCV + PC variant w/ systemic sx5,6 Multicentric presentation8 IL-6 implicated 10 First IL-6R Ab trial 12 HV and PC in English7 Systemic features3,4 AIDS association9 HHV-8 in CD11 1954, 1956 1965-1967 1969 1972 1978 1985 1989 1995 2005 1.Castleman B. NEJM. 1954;250:26-30. 2.Castleman B. Cancer 1956;9:822–30. 3.Lee SL. NEJM 1965;272:761-6. 4.Tung KS. Cancer 1967;20:525-36. 5.Flendrig JA. Folia Med 1969;12:119-20. 6.Flendrig JA. In: Clark RL, Cumley RW, eds. The Year Book of Cancer. Chicago: Year Book Medical; 1970:296-9. 7.Keller AR. Cancer 1972;29:670–83. 8.Gaba AR, Am J Clin Pathol 1978;69(1):86-90. 9.Lachant NA, Am J Clin Path 1985;83(1):27-33. 10. Yoshizaki K. Blood. 1989;74:1360-1367. 11. Soulier J. Blood 1995;86(4):1276-80. 12.Nishimoto Blood. 2005; 106:2627 – 2632.

  6. Predictors of Disease Variability Histology Therapy Castleman Disease Uni- v. Multi-centric KSV HIV Other Cytokines

  7. CD: Outline • History • Histology • Pathogenesis • Clinical aspects • Treatment • Future directions

  8. Hyaline vascular Plasma cell variant

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