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An Elusive Diagnosis of Castleman Disease.
Ann Thorac Surg Short Rep
September 2024
Department of Thoracic & Cardiovascular Surgery, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio.
We present the case of a 41-year-old man with an anterior mediastinal mass and constellation of clinical symptoms, including dyspnea, pleural effusions, pericardial effusions, renal insufficiency, and pancytopenia. After inconclusive results on several laboratory tests and a nondiagnostic surgical biopsy specimen, a specimen from a second surgical biopsy identified the patient's condition as Castleman disease associated with TAFRO (thrombocytopenia, anasarca, fevers, reticulin myelofibrosis, organomegaly) syndrome. This case highlights the importance of obtaining large tissue biopsy samples, interval follow-up, and acknowledging cognitive biases.
View Article and Find Full Text PDFMediastinal Castleman disease presenting as a paraspinal mass causing back pain and shortness of breath in a young adult.
Heliyon
December 2024
Department of Pathology, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo N Rd, South District, Taichung City, 402, Taiwan, ROC.
This case report details a rare presentation of unicentric Castleman disease (UCD), hyaline vascular type in a 22-year-old woman. The patient presented with a large, well-circumscribed mass in the paravertebral region causing back pain and shortness of breath. Diagnostic imaging and biopsy confirmed the diagnosis, and surgical excision led to a favorable outcome.
View Article and Find Full Text PDFComputed tomography findings of idiopathic multicentric Castleman disease subtypes.
J Clin Exp Hematop
December 2024
Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
This study retrospectively evaluated the computed tomography (CT) findings of idiopathic multicentric Castleman disease (iMCD) at a single center and compared the CT findings of iMCD-TAFRO with those of iMCD-non-TAFRO. CT images obtained within 30 days before diagnostic confirmation were reviewed for 20 patients with iMCD (8 men and 12 women, mean age 52.8 ± 12.
View Article and Find Full Text PDFThe Value of a Pet Scan in Selecting the Best Lymph Node to Biopsy, and Confirming the Diagnosis of Idiopathic Multicentric Castleman Disease with HLH And EBV Viremia in a Previously Healthy Adult.
Eur J Case Rep Intern Med
November 2024
Research Institute of the McGill University Health Centre, Montreal, Canada.
Introduction: Castleman disease (CD) is a rare lymphoproliferative disorder having a variegated clinical presentation. Diagnosis of the idiopathic HIV- and HHV8-negative multicentric CD (iMCD) subtype poses a challenge given its non-specific clinical manifestations. iMCD presents as diffuse lymphadenopathy with inflammatory manifestations, primarily driven by interleukin-6 (IL-6).
View Article and Find Full Text PDFIgG4-related disease for the hematologist.
Hematology Am Soc Hematol Educ Program
December 2024
Division of Hematology, University of British Columbia, Vancouver, British Columbia, Canada; and Division of Hematology, Dalhousie University, Halifax, Nova Scotia, Canada.
Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated disease with many important manifestations in hematopoietic and lymphoid tissue. IgG4 is the least naturally abundant IgG subclass, and the hallmark feature of IgG4-RD is markedly increased IgG4-positive plasma cells (with an IgG4 to IgG ratio >40%) in affected tissue, along with elevated polyclonal serum IgG and IgG4 in most patients. Histological diagnosis is essential, and other key features include storiform fibrosis, lymphoplasmacytic infiltrate, tissue eosinophilia, and obliterative phlebitis.
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