Castleman disease – An autoimmune mishap

Castleman disease is also known as giant lymph node hyperplasia or angiofollicular lymph node hyperplasia. This disorder belongs to the category of lymphoproliferative disorders. It is characterized by overgrowth of lymphatic cells. This disease is similar to lymphoma or lymphatic system cancers. This disease, itself, is not a cancer, but if left untreated, can cause the same. It may be limited to a single lymph node or can spread to lymph nodes in chest, neck, armpits and groin areas.

Types Of Castleman Disease:-

Unicentric Castleman disease:-
This is a localized form of disease affecting only one lymph node. The affected lymph node is usually situated in chest or abdominal region. This type of disease is associated with increased risk of lymphoma. However, once the lymph node is removed, individual is free from the threat. It usually affects individuals belonging to age group 30 to 40.

Symptoms and signs:-
Symptoms may or may not be present in all individuals. Some symptoms are as follows:-
1 Anemia
2. Cough
3. Feeling of fullness in chest
4. Difficulty breathing or swallowing
5. Sudden emergence of lump near neck, armpits or groin

Multicentric Castleman disease:-
This form of disease is more severe and can be life threatening. It usually affects lymph nodes and lymphatic tissues. This causes weakening of immune system. As a result, infection or failure or multiple organs becomes easier leading to death ultimately. In case cancers such as lymphoma or Kaposi’s sarcoma are present, risk of death becomes multifold. HIV /AIDS prevalence can worsen the situation. It usually affects persons belonging to age group 50-50.

Symptoms and signs:-
Symptoms may or may not be present in all individuals. Some symptoms are as follows:-

1. Fever
2. Chills and Night sweats
3. Nausea and vomiting
4. Loss of appetite
5. Unexpected weight loss
6. Weakness and fatigue
7. Lymph nodes enlargement especially in neck, throat and groin area
8. Liver enlargement
9. Spleen enlargement
10. Peripheral neuropathy- numbness in limbs on account of weakened nerves

Diagnosis of Castleman disease:-

1. Physical examination:-Examination of swollen lymph nodes to check their size and severity
2. Blood and urine tests: – To check for occurrence of anemia and other blood disorders/abnormalities.
3. Imaging techniques: Imaging techniques like X-ray, computerized tomography (CT) scan or magnetic resonance imaging (MRI) of chest, abdomen and pelvis. Severity of enlargement of lymph nodes can be determined through scanning.
4. Lymph node biopsy: -It is performed to differentiate between lymphoma and Castleman disease. It is usually performed under anesthesia. If the affected lymph node is situated in chest or abdominal region, more intensive procedure is required.

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