Overview
Patients with Castleman disease have cell overgrowth in the lymphatic system of the body. In most cases, the disease affects only a single lymph node, especially in the abdomen or the chest. It is a rare lymphoproliferative disorder.
Types of Castleman Disease
The following are the types of Castleman disease:
- Unicentric Castleman disease (UCD): It is also known as localized Castleman disease. This form of Castleman disease affects the lymph nodes of a particular body region.
- Multicentric Castleman disease (MCD): This form involves the lymph nodes of different body regions. Half of multicentric Castleman disease cases are due to HHV-8 infection in people with HIV or immunosuppression caused due to other conditions.
Symptoms of Castleman Disease
Most people with Castleman disease do not experience any symptoms. The disease is generally diagnosed when the patients undergo examination for some unrelated condition. Patients with Castleman disease have the following symptoms:
- Unexplained weight loss
- Fever
- Night sweats
- Fatigue
- Enlarged spleen and liver
- Nausea
At HCG Manavata Cancer Center, we have some of the best Castleman disease treatment doctors in Nashik, who are trained and experienced in accurately diagnosing Castleman disease cases and appropriately managing them.
Causes of Castleman Disease
The exact cause of Castleman disease remains unknown. However, there is an association between human herpesvirus 8 (HHV-8) and Castleman disease. The average age of people affected with unicentric Castleman disease is 35 years, while the multicentric form affects people in their 50s and 60s. Men are at a slightly higher risk than women.
Diagnosis of Castleman Disease
The following techniques are used for diagnosing Castleman disease:
- Physical Examination: The doctor may ask the patients if they suffer from fatigue, fever, weight loss, or night sweats.
- Laboratory Tests: The patient may undergo blood and urine tests. The blood tests may help determine the presence of elevated CRP or ESR, thrombocytopenia or thrombocytosis, anemia, polyclonal hypergammaglobulinemia, hypoalbuminemia, and renal dysfunction or proteinuria.
- Imaging Techniques: The doctor may recommend imaging techniques, such as MRI or CT scan, to determine the enlarged lymph nodes in the chest, neck, pelvis, and abdomen. The doctor may also use a PET scan to diagnose Castleman disease.
- Biopsy: The doctor obtains the tissue sample from the enlarged node and analyzes it in the laboratory. It also helps differentiate Castleman disease from lymphoma.
- Serological Examination: The patient may also undergo a serological examination for HIV and HHV-8 to determine their association with Castleman disease.
Treatment for Castleman Disease
HCG Manavata Cancer Center has a strong team of healthcare specialists who strive to deliver the best Castleman disease treatment in Nashik. The treatment for Castleman disease depends upon whether the patient has unicentric Castleman disease or multicentric Castleman disease.
Treatment for Unicentric Castleman Disease: The primary treatment for unicentric Castleman disease is surgery. The surgeon removes the lymph nodes affected by the disease. Depending upon the region affected by Castleman disease, patients may receive radiation therapy or chemotherapy before surgery. Radiation therapy and chemotherapy reduce the overgrowth of lymphatic cells and allow easy removal during surgery.
Treatment for Multicentric Castleman Disease: The treatment of multicentric Castleman disease is more challenging than unicentric Castleman disease. The doctor does not recommend surgery or radiation therapy for its management as multicentric Castleman disease is widespread. Some of the treatment options include:
- Chemotherapy: Chemotherapy involves administering drugs, by injection or oral, to destroy the overgrown lymphatic tissue. Oncologists recommend adding chemotherapy to the treatment strategy when immunotherapy does not work, or the patient has organ failure.
- Immunotherapy: Immunotherapy uses drugs that boost the immune system. The immune system attacks and kills the rapidly dividing cells. These drugs help in blocking the action of excessively produced proteins in patients with Castleman disease.
- Corticosteroids: These medications reduce swelling and inflammation in patients with Castleman disease.
- Antiviral Drugs: These drugs are recommended when patients have either HIV or HHV-8 or both.
Frequently Asked Questions
What are the complications of Castleman disease?
There are several complications in patients with Castleman disease. These include increased risk of lymphoma and Kaposi’s sarcoma. In patients without treatment for multicentric form, complications include infections that may result in organ damage and life-threatening events.
How should I prevent Castleman disease?
No method completely prevents the occurrence of Castleman disease, as there is no known cause. However, some measures may effectively reduce the risk of this condition by lowering the risk of HIV infection. These measures include:
- Consider safe sex practices – avoid having multiple sex partners
- Avoid sharing needles while using intravenous drugs
- Avoid drug abuse
What is the prognosis for Castleman disease?
The prognosis of patients suffering from unicentric disease is excellent as the affected lymph node is removed through surgery. If adequate treatment is provided, the unicentric form of Castleman disease does not affect life expectancy.
The prognosis of multicentric Castleman disease depends upon the spread of the disease. Therefore, in some patients, the treatment is continuous to prevent the worsening of the disease.
Is Castleman disease a contagious disease?
Castleman disease is not known to be contagious. There is no association between this condition and factors like food, environmental factors, and lifestyle. Further, there are no reports of spreading this disease from one person to another as well.
Is Castleman disease cancer?
Castleman disease is not cancer. The symptoms and diagnostic tests are similar to those of certain cancers, such as lymphoma. There is an increased risk of hematological malignancies in a patient with idiopathic multicentric Castleman disease.