Diagnostic challenges in patients with Castleman disease, a single center experience from Hungary

Autor: Boglárka Brúgós, Zsófia Simon, Gábor Méhes, Árpád Illés, György Pfliegler
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Pathology and Oncology Research, Vol 30 (2024)
Druh dokumentu: article
ISSN: 1532-2807
80965946
DOI: 10.3389/pore.2024.1611785
Popis: Castleman disease is a rare and atypical lymphoproliferative disorder characterized by diverse clinical manifestations. It has both unicentric and multicentric forms, the latter with further subdivisions, i.e., human herpesvirus 8-associated and idiopathic forms. The diagnosis of Castleman disease is often delayed, as it is rare, and because it shares clinical features with different autoimmune, inflammatory, and malignant lymphoproliferative disorders. The first-line treatment in unicentric form is mainly surgical, while in idiopathic Castleman disease, anti-interleukin-6 treatment is the therapy of choice. In virus-associated diseases, antiretroviral therapy and rituximab are recommended. In Hungary, only a few cases of Castleman disease have been published. This report presents our two decades of experience in the challenging diagnosis and management of this rare disorder, most properly underdiagnosed in Hungary. We provide insights into seven unicentric and five idiopathic multicentric Castleman disease cases, the latter ones especially highlighting the diagnostic and therapeutic challenges due to the variable and unique clinical features both of patients and diseases, e.g., bronchiolitis obliterans, stage IV diabetic renal failure, anti-HBc positivity, siltuximab treatment period, respectively.
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