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Extranodal multicentric Castleman's disease with cutaneous involvement

H G Skelton1, K J Smith

  • 1Laboratory Corporation of America, Herndon, Virginia, USA.

Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
|April 29, 1998
PubMed
Summary

Castleman's disease (CAD) can manifest in the skin. This report details a rare case of multicentric cutaneous Castleman's disease without lymph node involvement, offering new insights into extranodal presentations.

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Area of Science:

  • Immunology
  • Pathology
  • Dermatology

Background:

  • Castleman's disease (CAD) is a rare lymphoproliferative disorder.
  • Typically affects lymph nodes, with extranodal involvement being uncommon.
  • Etiology may involve immune dysregulation triggered by infections or drugs.

Observation:

  • A 72-year-old woman presented with multiple, diffuse cutaneous nodules.
  • Lesions measured 2-5 cm and appeared over several months.
  • The patient experienced mild joint pain but was otherwise asymptomatic.

Findings:

  • Histopathology revealed features of Castleman's disease in the skin nodules.
  • Key findings included lymphoid follicles with contracted germinal centers and expanded mantle zones.
  • Perivascular sclerotic collagen bands, histiocyte aggregates, lymphoplasmacytic infiltrate, and vascular proliferation were noted.

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Implications:

  • This case represents a potential new manifestation of Castleman's disease.
  • Highlights the possibility of multicentric cutaneous CAD without concurrent lymphadenopathy.
  • Suggests the need to consider Castleman's disease in the differential diagnosis of unexplained cutaneous nodules.