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Published on: September 20, 2024
Castleman Disease Pathogenesis
David C Fajgenbaum1, Dustin Shilling1
1Division of Translational Medicine and Human Genetics, Hospital of the University of Pennsylvania, 3400 Spruce Street, Silverstein 5, Suite S05094, Philadelphia, PA 19104, USA.
Insights
Castleman disease (CD) encompasses diverse disorders affecting lymph nodes. This review details the distinct causes, cellular players, and signaling pathways driving each of the four CD subtypes.
Area of Science:
- Immunology
- Pathology
- Oncology
Background:
- Castleman disease (CD) is a complex group of disorders characterized by specific lymph node abnormalities.
- CD presents with varied histopathologic features, including germinal center changes, prominent dendritic cells, and lymphoproliferation.
Purpose of the Study:
- To summarize the current understanding of the etiology and pathogenesis of Castleman disease subtypes.
- To elucidate the specific causes, cellular mechanisms, signaling pathways, and cytokines involved in each CD subtype.
Main Methods:
- Literature review and synthesis of existing research on Castleman disease.
- Comparative analysis of the four recognized subtypes: unicentric CD, HHV-8-associated multicentric CD, POEMS-associated multicentric CD, and idiopathic multicentric CD.
Main Results:
- Each of the four Castleman disease subtypes has a distinct underlying cause and pathogenesis.
- Key differences involve viral association (HHV-8), association with POEMS syndrome, or idiopathic origins.
- Common pathogenic themes include lymphoproliferation and dysregulated cytokine signaling.
Conclusions:
- Understanding the specific pathogenesis of each CD subtype is crucial for targeted therapeutic strategies.
- Further research into the molecular mechanisms driving CD subtypes will improve patient outcomes.
Abstract:
Castleman disease (CD) describes a group of heterogeneous disorders with common lymph node histopathologic features, including atrophic or hyperplastic germinal centers, prominent follicular dendritic cells, hypervascularization, polyclonal lymphoproliferation, and/or polytypic plasmacytosis. The cause and pathogenesis of the four subtypes of CD (unicentric CD; human herpesvirus-8-associated multicentric CD; polyradiculoneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes [POEMS]-associated multicentric CD; and idiopathic multicentric CD) vary considerably. This article provides a summary of our current understanding of the cause, cell types, signaling pathways, and effector cytokines implicated in the pathogenesis of each subtype.
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