angiofollicular lymph node hyperplasia; Castleman lymphadenopathy

Introduction

Currently considered to be a systemic disease; may be multicentric.

Etiology

unknown Some cases associated with human herpes virus type 8.

Microscopic pathology

enlarged lymph nodes, two pattern types

• hyaline vascular type: solitary masses of lymphoid tissue containing concentric perivascular aggregates of lymphocytes
• plasma cell type: sheets of interfollicular plasma cells

Clinical manifestations

• lymphadenopathy
  • abdomen or mediastinum (younger patients)
  • multicentric (older patients)
  • hepatosplenomegaly
• case presented with hematuria after hiking
• retroperitoneal mass (case report)

Laboratory

• complete blood count (CBC) may show anemia
• lymph node biopsy

Radiology

• chest X-ray
  • hilar or mediastinal adenopathy
• abdominal ultrasound -> abdominal CT
• magnetic resonance imaging (MRI) of the abdomen & pelvis annually in follow-up

Complications

• may progress to lymphoma or plasmacytoma

Differential diagnosis

• Castleman like changes may be seen in
  • autoimmune disease
  • primary immune deficiencies
  • Kaposi sarcoma
  • late phase of HIV-associated adenopathy
• large accumulations of plasma cells is nonspecific and may be seen in
  • rheumatoid arthritis
  • lues
  • angioimmunoblastic lymphadenopathy
  • POEMS syndrome
• lymphoma

Management

• surgical resection as indicated
• radiation therapy

More general terms

• lymphoid tissue disease; lymphoid disorder

Patient information

angiofollicular lymph node hyperplasia (Castleman disease) patient information