Radiation Oncology/Miscellaneous lymphoid

Miscellaneous lymphoid disorders, including lymphoproliferative disorders.

Castleman disease

Synonyms: angiofollicular lymph node hyperplasia, giant lymph node hyperplasia, lymphoid hamartoma, follicular lymphoreticuloma.

Clinically presents as lymphadenopathy with or without constitutional symptoms.

Pathology: is neither purely reactive nor purely neoplastic. Etiology is unclear. HHV-8 has been implicated.

Multicentric disease can be rapidly progressive with the potential for malignant transformation.

Surgery is standard of care for unicentric Castleman disease. RT can be used with doses around 40 Gy. Combination chemotherapy and steroids are used for multicentric Castleman disease.

Reviews:

• 2010 - PMID 20864917 Full text -- "Castleman Disease in the 21st Century: An Update on Diagnosis, Assessment, and Therapy" (van Rhee F, Clin Adv Hematol Oncol. 2010 July;8(7):486-98.)
• PMID 11505414, 2001 — "Treatment of unicentric and multicentric Castleman disease and the role of radiotherapy." Chronowski GM et al. Cancer. 2001 Aug 1;92(3):670-6.