ENFERMEDAD DE CASTLEMAN LOCALIZADA EN REGIÓN CERVICAL

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Abstract

La enfermedad de Castleman (EC) es un proceso linfo-proliferativo poco frecuente que se caracteriza por hiperplasia de los ganglios linfáticos. Existen dos variedades histológicas bien diferenciadas la Hialino-vascular y las plasmo-celular, que a su vez pueden ser localizadas o multicentricas. La forma hialino-vascular suele ser asintomática y localizada en mediastino mientras que las plasmo celular se presenta frecuentemente con signo-sintomatología sistémica y suelen ser difusa o multicentrica. Por su importancia, la poca frecuencia, su localización y otras características. Se presenta un caso de EC tipo hialino-vascular en región cervical izquierda. , y como en todos los casos publicados, la exeresis de la adenopatía fue diagnóstica y terapéutica.

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Most cited references 14

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Hyaline-vascular and plasma-cell types of giant lymph node hyperplasia of the mediastinum and other locations.

Joan B. Castleman, Evan Keller, L Hochholzer (1972)

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The management of unicentric and multicentric Castleman's disease: a report of 16 cases and a review of the literature.

Doug Brooks, Murray F. Brennan, Helen J Lewis … (1999)

Castleman's disease (CD), or angiofollicular lymph node hyperplasia, creates both diagnostic and therapeutic dilemmas for most physicians. For patients with this rare and poorly understood disease, the optimal therapy is unknown. The authors report their experience during the years 1986-1997 with this uncommon clinicopathologic entity. Sixteen patients with a histologic diagnosis of CD were identified in the pathology database. Unicentric disease was defined as a solitary mass. Multicentric disease compromised patients with widespread lymphadenectomy. Clinical, radiologic, and laboratory data were analyzed to evaluate treatment response. The study group consisted of 16 patients classified into 3 clinicopathologic groups: hyaline-vascular, plasma cell, and "mixed." Of those patients who underwent complete surgical excision of a unicentric hyaline-vascular CD mass (n = 8), all remain symptom free without clinical or radiographic recurrence. Two patients remain asymptomatic following partial resection or radiation therapy for an unresectable unicentric hyaline-vascular CD mass. Two patients with multicentric hyaline-vascular CD are currently in complete remission following adjuvant therapy. Multicentric plasma cell CD was present in a single patient. This patient (who underwent surgical and systemic therapy) died of disease within 4 months of presentation. Three patients with unicentric hyaline-vascular/plasma cell-CD remain symptom free following either complete resection or observation. The authors recommend surgical resection for patients with the unicentric variant of CD. Surgical removal of a unicentric mass of hyaline-vascular or hyaline-vascular/plasma cell type is curative. Partial resection, radiotherapy, or observation alone may avoid the need for excessively aggressive therapy. Patients with multicentric disease, either hyaline-vascular or plasma cell type, do not benefit from surgical management and should be candidates for multimodality therapy, the nature of which has yet to be defined.

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The clinical behavior of localized and multicentric Castleman disease.

F Cabanillas, J Herrada, Kim L. Rice … (1998)

Castleman disease, an unusual condition of unknown cause consisting of a massive proliferation of lymphoid tissue, remains a clinicopathologic diagnosis. Three histologic variants (hyaline vascular, plasma-cell, and mixed) and two clinical types (localized and multicentric) of Castleman disease have been described. To analyze the clinical features, management, and outcome of patients with Castleman disease. Case series. University referral hospitals. All patients with Castleman disease who were seen at Texas Medical Center, Houston, Texas, between 1977 and 1995. Surgical excision for localized disease; surgery, combination chemotherapy, or prednisone for multicentric disease. Patients were identified according to initial presentation as having localized or multicentric Castleman disease. Patients within each group were further subdivided according to whether they had hyaline vascular, plasma-cell, or mixed disease. Data from 15 patients were analyzed. All 7 patients with localized disease underwent surgical excision and remain free of disease. The 8 patients with multicentric disease were further subdivided according to initial treatment: Three patients who received combination chemotherapy are currently alive and free of disease; 2 patients treated with prednisone are alive but have needed intermittent maintenance therapy for disease reactivations; and 2 patients treated with surgery only have died, 1 of infectious complications and 1 of non-Hodgkin lymphoma. Localized and multicentric Castleman disease are different clinical disorders with overlapping histologic features. Localized disease can be cured with surgery, but complete remissions in patients with multicentric disease have been achieved only with chemotherapy or prednisone given at the time of diagnosis.