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Date of last update: 10/21/2017.

Forum Name: Lymphoma

Question: Castleman's Disease

 lriggs1 - Wed Feb 27, 2008 6:35 pm

I don't think my earlier question posted because while editing it, it disappeared. It was several hrs ago and it says that I don't have any postings so I hope that's right.

I have the plasma cell variant of castleman's disease (CD). I recieved 8 rituxan treatments from 12/04-2/05 and then surgery in 5/05 to remove the effected lymph nodes. Prior to my diagnosis, I received 8 infusions of ferlecit for anemia of which I've had no problems since.

I've experienced CD type symptoms off and on since my treatment/surgery but the drs say that it's not CD related because my scans show no evidence of tumors. I've recently began having difficulty with feeling full after only eating small amounts and actually have to lean back to be comfortable or to breathe normally. I haven't seen my dr but did have lab work about two weeks ago. My sed rate was normal but my CRP was 14.2 and my white blood cell count was 3,400 (normal for this lab is 5,000-10,000). My PCP suggested I contact my oncologist. I do have an appt with my onc. the end of March.

My question is even though my wbc isn't that low, could my bout with multiple "bugs" over the past couple of months be related? I've been ill for the past 4 days with a temp between 100-102, chills, sweats, aches, etc. And, should I be proactive with a sense of urgency in light of my symptoms and test results or just be patient and wait for my end of march appt?

Any advice/info would be appreciated.

 Dr. Safaa Mahmoud - Fri Oct 10, 2008 7:40 am

User avatar Hello,

Castleman's disease, is a benign lymphoproliferative disorder (lymphatic tissue growth in any part throughout the body).

Castleman’s disease can be classified as a) unicentric vs. multicentric, based on clinical and radiological results, b) hyaline vascular vs. plasmacytic vs. mixed cellularity variety based on histopathology and c) as HIV negative versus HIV positive based on the HIV status of the patient. All three factors are taken into consideration in the management of patients.

Unicentric Castleman’s Disease usually presents as a slow growing solitary mass (LN in mediastinium or mesenteries). The disease is not associated with constitutional symptoms or elevation of acute phase reactants (ESR and CRP). Prognosis is excellent and cure is achieved n 90-95% cases with surgical resection.

To the contrary, multicentric Castleman’s Disease is associated with “B” symptoms (fever, night sweats, weight loss and fatigue) and elevated acute phase reactants. It requires systemic therapy and progression to lymphoma is not uncommon.

A plasma cell type of Castleman's Disease is characterized by the presence of sheets of plasma cells of plasma cells in the interfollicular spaces. This disease variant commonly presents as multicenteric.

Sometimes steroids and/or rituxan are given before surgery to shrink bulky or inoperable disease. For all cases of localized disease cure is the primary goal and disease progression is quite rare.

Considering your strong family history, your symptoms are concerning and should be properly investigated to exclude disease relapse and progression.

As your doctor advised, consultation of an oncologist is essential.
Please keep us updated.
Best regards.

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