Castleman's disease of the spleen

Acta Chir Belg. 2017 Jun;117(3):203-208. doi: 10.1080/00015458.2016.1246273. Epub 2016 Oct 24.

Abstract

Introduction: Castleman's disease (CD), also known as giant or angiofolicular lymphoid hyperplasia or lymphoid hamartoma, is a group of atypical lymphoproliferative disorders that share common lymph node histological features and may be localized either to a single lymph node (unicentric) or occur systemically (multicentric).

Patient and method: Herein, we present a rare case of a of 75-year-old female patient who was referred to our department and after a thorough work-up, underwent splenectomy with synchronous resection of an accessory spleen, splenic artery lymph nodes, and splenic hilar lymph nodes due to splenic involvement in a multicentric CD.

Results: The pathology of the specimens led to the conclusion that it was a case of polycentric HHV-8-positive CD, affecting the spleen, the accessory spleen, and the lymph nodes.

Conclusions: Incidence of this rare condition is believed to be approximately 0.001-0.05%. CD has been linked to the human immunodeficiency virus (HIV), human herpes virus 8 (HHV-8), and is associated with malignancies. The pathogenesis mechanism is considered to be a dysregulation and hypersecretion of cytokines, either idiopathic or secondary to a viral infection, with the latter considered the most frequent. Solid organ involvement is very rare as is splenic involvement.

Keywords: Castleman’s disease; lymph nodes; spleen disorders.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Castleman Disease / diagnosis*
  • Castleman Disease / surgery
  • Female
  • Humans
  • Splenectomy
  • Splenic Diseases / diagnosis*
  • Splenic Diseases / surgery