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A retrospective study of 44 patients with head and neck Castleman's disease
Taiqin Wang1, Xiaoqiang Chen1, Wei Chen1
1Department of Otolaryngology, Fujian Medical University Union Hospital, 29# Xinquan Road, Fuzhou, 350001, Fujian, China.
Insights
Unicentric Castleman's disease (UCD) presents as asymptomatic lymph node enlargement, treated with surgery. Multicentric Castleman's disease (MCD) has complex symptoms, a poor prognosis, and may benefit from anti-IL-6 therapy.
Area of Science:
- Oncology
- Pathology
- Immunology
Background:
- Castleman's disease (CD) is a rare lymphoproliferative disorder.
- Head and neck involvement is a significant clinical presentation of CD.
- Understanding the distinct features of unicentric (UCD) and multicentric (MCD) forms is crucial for patient management.
Purpose of the Study:
- To elucidate the clinical and pathological characteristics of head and neck Castleman's disease.
- To analyze treatment strategies and prognostic factors for UCD and MCD.
- To differentiate the disease course and outcomes between UCD and MCD.
Main Methods:
- Retrospective analysis of 44 head and neck Castleman's disease patients diagnosed between 2008 and 2021.
- Classification of patients into unicentric CD (UCD, n=20) and multicentric CD (MCD, n=24).
- Evaluation of clinical data, imaging, laboratory findings, and treatment outcomes.
Main Results:
- UCD patients were younger, predominantly female, with asymptomatic single lymphadenectasis and favorable prognosis.
- MCD patients were older, predominantly male, presenting with systemic symptoms including hepatosplenomegaly, pneumonia, anemia, and poor prognosis.
- Two MCD cases were associated with systemic lupus erythematosus (SLE).
Conclusions:
- Unicentric Castleman's disease typically presents as isolated, asymptomatic lymphadenopathy, with complete surgical resection being the primary treatment.
- Multicentric Castleman's disease exhibits complex clinical manifestations and a poorer prognosis, with potential efficacy of anti-interleukin-6 (IL-6) therapy.
Purpose:
To explore the clinical and pathological features, therapy and prognosis of Castleman's disease (CD) in the head and neck.
Methods:
We retrospectively analyzed the clinical and pathological data of 44 patients with head and neck CD who were diagnosed in the Fujian Medical University Union hospital (Fujian, China) between May 2008 and June 2021. According to the clinical classification, they were divided into two groups, the unicentric CD (UCD, n = 20) and the multicentric CD (MCD, n = 24). Their clinical features, imaging findings, laboratory examination, and treatment results were, respectively, analyzed.
Results:
The age of UCD patients was younger than that of MCD patients. Most of the UCD patients (80%) were female, with asymptomatic single lymphadenectasis, and the prognosis was favorable; while 70.8% of the MCD patients were male, with multiple lymph nodes throughout the body, and more prone to hepatosplenomegaly, pneumonia, serous effusion, anemia, hypoalbuminemia, elevated globulin, coagulation disorders, etc., the prognosis was bleak. Two cases of MCD patients were with systemic lupus erythematosus (SLE).
Conclusions:
UCD usually manifests as asymptomatic single lymph node enlargement, complete surgical resection was the mainstay of treatment modality. MCD has relatively complicated clinical symptoms and poor prognosis, and anti-IL-6 therapy may be effective.
