open access

Vol 86, No 1 (2018)
REVIEWS
Published online: 2018-02-28
Submitted: 2017-11-13
Accepted: 2018-02-14
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The role of surgical resection in Unicentric Castleman’s disease: a systematic review

Sofoklis Mitsos, Alexandros Stamatopoulos, Davide Patrini, Robert S George, David R Lawrence, Nikolaos Panagiotopoulos
DOI: 10.5603/ARM.2018.0008
·
Pubmed: 29490420
·
Adv Respir Med 2018;86(1):36-43.

open access

Vol 86, No 1 (2018)
REVIEWS
Published online: 2018-02-28
Submitted: 2017-11-13
Accepted: 2018-02-14

Abstract

Introduction: Castleman’s disease is a rare benign lymphoproliferative disorder of unknown etiology. The disease occurs in two
clinical forms with different prognoses, treatments and symptoms: a unicentric form (UCD), which is solitary, localized, and a multicentric
form characterized by generalized lymphadenopathy and systemic symptoms. This article aims to review the current
literature to consolidate the evidence surrounding the curative potential of surgical treatment to the unicentric type.
Material and methods: A systematic review of English-language literature was performed and databases (Medline, Pubmed,
the Cochrane Database and grey literature) were searched to identify articles pertaining to the treatment of unicentric form of
Castleman’s disease. Each article was critiqued by two authors using a structured appraisal tool, and stratified according to the
level of evidence.
Results: After application of inclusion criteria, 14 studies were included. There were no prospective randomized control studies
identified. One meta-analysis including 278 patients with UCD reported that resective surgery is safe and should be considered
the gold standard for treatment. Seven retrospective studies enhance this standpoint. Radiotherapy (RT) has been used in six
studies with controversial results.
Conclusions: We conclude that surgical resection appears to be the most effective treatment for Unicentric Castleman’s Disease
of the thoracic cavity. Radiotherapy can also achieve clinical response and cure in selected patients.

Abstract

Introduction: Castleman’s disease is a rare benign lymphoproliferative disorder of unknown etiology. The disease occurs in two
clinical forms with different prognoses, treatments and symptoms: a unicentric form (UCD), which is solitary, localized, and a multicentric
form characterized by generalized lymphadenopathy and systemic symptoms. This article aims to review the current
literature to consolidate the evidence surrounding the curative potential of surgical treatment to the unicentric type.
Material and methods: A systematic review of English-language literature was performed and databases (Medline, Pubmed,
the Cochrane Database and grey literature) were searched to identify articles pertaining to the treatment of unicentric form of
Castleman’s disease. Each article was critiqued by two authors using a structured appraisal tool, and stratified according to the
level of evidence.
Results: After application of inclusion criteria, 14 studies were included. There were no prospective randomized control studies
identified. One meta-analysis including 278 patients with UCD reported that resective surgery is safe and should be considered
the gold standard for treatment. Seven retrospective studies enhance this standpoint. Radiotherapy (RT) has been used in six
studies with controversial results.
Conclusions: We conclude that surgical resection appears to be the most effective treatment for Unicentric Castleman’s Disease
of the thoracic cavity. Radiotherapy can also achieve clinical response and cure in selected patients.

Get Citation

Keywords

castleman disease, lymphadenopathy, mediastinum, treatment outcome

About this article
Title

The role of surgical resection in Unicentric Castleman’s disease: a systematic review

Journal

Advances in Respiratory Medicine

Issue

Vol 86, No 1 (2018)

Pages

36-43

Published online

2018-02-28

DOI

10.5603/ARM.2018.0008

Pubmed

29490420

Bibliographic record

Adv Respir Med 2018;86(1):36-43.

Keywords

castleman disease
lymphadenopathy
mediastinum
treatment outcome

Authors

Sofoklis Mitsos
Alexandros Stamatopoulos
Davide Patrini
Robert S George
David R Lawrence
Nikolaos Panagiotopoulos

References (24)
  1. CASTLEMAN B, TOWNE VW. Case records of the Massachusetts General Hospital: Case No. 40231. N Engl J Med. 1954; 250(23): 1001–1005.
  2. Castleman B, Iverson L, Menendez VP. Localized mediastinal lymphnode hyperplasia resembling thymoma. Cancer. 1956; 9(4): 822–830.
  3. Flendrig JA. Benign giant lymphoma: clinicopathologic correlation study. In: Clark RL. ed. The year book of cancer. Year Book Medical Publishers, Chicago 1970: 296–299.
  4. Keller AR, Hochholzer L, Castleman B. Hyaline-vascular and plasma-cell types of giant lymph node hyperplasia of the mediastinum and other locations. Cancer. 1972; 29(3): 670–683.
  5. McCarty MJ, Vukelja SJ, Banks PM, et al. Angiofollicular lymph node hyperplasia (Castleman's disease). Cancer Treat Rev. 1995; 21(4): 291–310.
  6. Bartoli E, Massarelli G, Soggia G, et al. Multicentric giant lymph node hyperplasia. A hyperimmune syndrome with a rapidly progressive course. Am J Clin Pathol. 1980; 73(3): 423–426.
  7. Gaba AR, Stein RS, Sweet DL, et al. Multicentric giant lymph node hyperplasia. Am J Clin Pathol. 1978; 69(1): 86–90.
  8. Frizzera G. Castleman's disease: more questions than answers. Hum Pathol. 1985; 16(3): 202–205.
  9. Shahidi H, Myers JL, Kvale PA. Castleman's disease. Mayo Clin Proc. 1995; 70(10): 969–977.
  10. Katano H, Sata T. An attractive relation of human herpesvirus-8 with multicentric Castleman's disease. Intern Med. 1999; 38(3): 221–222.
  11. Talat N, Belgaumkar AP, Schulte KM. Surgery in Castleman's disease: a systematic review of 404 published cases. Ann Surg. 2012; 255(4): 677–684.
  12. Ye Bo, Gao SG, Li W, et al. A retrospective study of unicentric and multicentric Castleman's disease: a report of 52 patients. Med Oncol. 2010; 27(4): 1171–1178.
  13. Luo JM, Li S, Huang H, et al. Clinical spectrum of intrathoracic Castleman disease: a retrospective analysis of 48 cases in a single Chinese hospital. BMC Pulm Med. 2015; 15: 34.
  14. Chen CH, Liu HC, Tung KY, et al. Surgical outcome of superficial and deep Castleman disease. ANZ J Surg. 2007; 77(5): 339–343.
  15. Ko SF, Ng SH, Hsieh MJ, et al. Castleman disease of the pleura: experience with eight surgically proven cases. Ann Thorac Surg. 2003; 76(1): 219–224.
  16. Mohanna S, Sanchez J, Ferrufino JC, et al. Characteristics of Castleman's disease in Peru. Eur J Intern Med. 2006; 17(3): 170–174.
  17. Zhou N, Huang CW, Huang C, et al. The characterization and management of Castleman's disease. J Int Med Res. 2012; 40(4): 1580–1588.
  18. Kim JH, Jun TG, Sung SW, et al. Giant lymph node hyperplasia (Castleman's disease) in the chest. Ann Thorac Surg. 1995; 59(5): 1162–1165.
  19. Bowne WB, Lewis JJ, Filippa DA, et al. The management of unicentric and multicentric Castleman's disease: a report of 16 cases and a review of the literature. Cancer. 1999; 85(3): 706–717.
  20. Chronowski GM, Ha CS, Wilder RB, et al. Treatment of unicentric and multicentric Castleman disease and the role of radiotherapy. Cancer. 2001; 92(3): 670–676.
  21. Uysal B, Demiral S, Gamsiz H, et al. Castleman's disease and radiotherapy: a single center experience. J Cancer Res Ther. 2015; 11(1): 170–173.
  22. Keller AR, Hochholzer L, Castleman B. Hyaline-vascular and plasma-cell types of giant lymph node hyperplasia of the mediastinum and other locations. Cancer. 1972; 29(3): 670–683.
  23. Neuhof D, Debus J. Outcome and late complications of radiotherapy in patients with unicentric Castleman disease. Acta Oncol. 2006; 45(8): 1126–1131.
  24. Parez N, Bader-Meunier B, Roy CC, et al. Paediatric Castleman disease: report of seven cases and review of the literature. Eur J Pediatr. 1999; 158(8): 631–637.

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