Castleman Disease: Insights from a Case Series and Literature Review

Castleman disease (CD), a rare lymphoproliferative disorder with unicentric (UCD) and multicentric (MCD) subtypes, presents significant diagnostic and therapeutic challenges due to its clinical heterogeneity. This case series of four patients highlights rare and diverse clinical presentations of CD,...

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Main Authors: Jerin James, Sanudev Sadanandan Vadakke Puthiyottil, Johan George, Arathi Edayattil, Vivek Mathew James, Swapna Dominic, Supriya N. K.
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd.
Series:Indian Journal of Medical and Paediatric Oncology
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1810074
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author Jerin James
Sanudev Sadanandan Vadakke Puthiyottil
Johan George
Arathi Edayattil
Vivek Mathew James
Swapna Dominic
Supriya N. K.
author_facet Jerin James
Sanudev Sadanandan Vadakke Puthiyottil
Johan George
Arathi Edayattil
Vivek Mathew James
Swapna Dominic
Supriya N. K.
author_sort Jerin James
collection DOAJ
description Castleman disease (CD), a rare lymphoproliferative disorder with unicentric (UCD) and multicentric (MCD) subtypes, presents significant diagnostic and therapeutic challenges due to its clinical heterogeneity. This case series of four patients highlights rare and diverse clinical presentations of CD, including atypical anatomical sites and paraneoplastic pemphigus. Diagnostic challenges included differentiating CD from malignancies or autoimmune disorders, emphasizing the critical role of histopathology. UCD pathogenesis may involve follicular dendritic cell mutations, whereas MCD subtypes are driven by human herpesvirus (HHV)-8-associated viral interleukin-6 or idiopathic cytokine dysregulation. Treatment strategies varied, with surgery preferred for UCD and immunomodulators (siltuximab, rituximab) for MCD. Challenges such as limited standardized protocols in resource-constrained settings and biomarker variability underscore the need for individualized therapy. Emerging approaches, including cytokine-targeted therapies and bortezomib, show promise for refractory cases. This study reinforces the importance of multidisciplinary collaboration, early histopathological diagnosis, and long-term monitoring to optimize outcomes. By integrating clinical experiences with literature, it advocates for refined diagnostic criteria and context-specific therapeutic algorithms, urging further research to address gaps in managing this complex disease.
format Article
id doaj-art-27c38fcdb2354d3ba0f68d3d9ebe4e0d
institution Kabale University
issn 0971-5851
0975-2129
language English
publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format Article
series Indian Journal of Medical and Paediatric Oncology
spelling doaj-art-27c38fcdb2354d3ba0f68d3d9ebe4e0d2025-08-20T03:51:29ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Medical and Paediatric Oncology0971-58510975-212910.1055/s-0045-1810074Castleman Disease: Insights from a Case Series and Literature ReviewJerin James0https://orcid.org/0009-0004-2999-0391Sanudev Sadanandan Vadakke Puthiyottil1https://orcid.org/0000-0002-0105-2705Johan George2Arathi Edayattil3Vivek Mathew James4Swapna Dominic5Supriya N. K.6Department of Medical Oncology, Government Medical College, Kozhikode, Kerala, IndiaDepartment of Medical Oncology, Government Medical College, Kozhikode, Kerala, IndiaDepartment of Medical Oncology, Government Medical College, Kozhikode, Kerala, IndiaDepartment of Medical Oncology, Government Medical College, Kozhikode, Kerala, IndiaDepartment of Nuclear Medicine, Government Medical College, Kozhikode, Kerala, IndiaDepartment of Dermatology, Government Medical College, Kozhikode, Kerala, IndiaDepartment of Pathology, Government Medical College, Kozhikode, Kerala, IndiaCastleman disease (CD), a rare lymphoproliferative disorder with unicentric (UCD) and multicentric (MCD) subtypes, presents significant diagnostic and therapeutic challenges due to its clinical heterogeneity. This case series of four patients highlights rare and diverse clinical presentations of CD, including atypical anatomical sites and paraneoplastic pemphigus. Diagnostic challenges included differentiating CD from malignancies or autoimmune disorders, emphasizing the critical role of histopathology. UCD pathogenesis may involve follicular dendritic cell mutations, whereas MCD subtypes are driven by human herpesvirus (HHV)-8-associated viral interleukin-6 or idiopathic cytokine dysregulation. Treatment strategies varied, with surgery preferred for UCD and immunomodulators (siltuximab, rituximab) for MCD. Challenges such as limited standardized protocols in resource-constrained settings and biomarker variability underscore the need for individualized therapy. Emerging approaches, including cytokine-targeted therapies and bortezomib, show promise for refractory cases. This study reinforces the importance of multidisciplinary collaboration, early histopathological diagnosis, and long-term monitoring to optimize outcomes. By integrating clinical experiences with literature, it advocates for refined diagnostic criteria and context-specific therapeutic algorithms, urging further research to address gaps in managing this complex disease.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1810074case reportCastleman diseaseunicentric CDmulticentric CDhuman herpesvirus 8
spellingShingle Jerin James
Sanudev Sadanandan Vadakke Puthiyottil
Johan George
Arathi Edayattil
Vivek Mathew James
Swapna Dominic
Supriya N. K.
Castleman Disease: Insights from a Case Series and Literature Review
Indian Journal of Medical and Paediatric Oncology
case report
Castleman disease
unicentric CD
multicentric CD
human herpesvirus 8
title Castleman Disease: Insights from a Case Series and Literature Review
title_full Castleman Disease: Insights from a Case Series and Literature Review
title_fullStr Castleman Disease: Insights from a Case Series and Literature Review
title_full_unstemmed Castleman Disease: Insights from a Case Series and Literature Review
title_short Castleman Disease: Insights from a Case Series and Literature Review
title_sort castleman disease insights from a case series and literature review
topic case report
Castleman disease
unicentric CD
multicentric CD
human herpesvirus 8
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1810074
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AT arathiedayattil castlemandiseaseinsightsfromacaseseriesandliteraturereview
AT vivekmathewjames castlemandiseaseinsightsfromacaseseriesandliteraturereview
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