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COX2-related multicentric mixed-type Castleman's disease in a young man

Nature Clinical Practice Oncology volume 2, pages 370–375 (2005)Cite this article

Abstract

Background A 34-year-old male presented with a 5-month history of fatigue, anorexia, low fever, night sweats, and oliguria with edema of the eyelid, exacerbated by abdominal distension and mild diarrhea of 3 weeks duration. Physical examination showed positive signs of ascites, palpable spleen, slight abdominal tenderness and mild rebound tenderness in the lower abdomen, and edema of the lower limbs. Initial laboratory tests revealed abnormal liver biochemistry and increased protein concentration in the urine. Chest X-ray showed minimal pleural effusion in both sides of the thoracic cavity, and ultrasound detected moderate ascites, several small lymph nodes in the retroperitoneum, and mild splenomegaly with widening of the splenic vein. A lymph node biopsy established the diagnosis, and cytokine analysis in the serum revealed COX2 as the possible mediator.

Investigations Abdominal paracentesis, chest X-ray, abdominal ultrasound, thoracic and abdominal CT scans, gastroscopy, colonoscopy, biopsies of the liver, bone marrow and lymph nodes, immunophenotype staining for lymphocytes, cytokine analysis.

Diagnosis COX2-related multicentric mixed-type Castleman's disease.

Management Chemotherapy and COX2 inhibitors.

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Figure 1: Percutaneous liver biopsy with hematoxylin and eosin staining.
Figure 2: Bone-marrow biopsy revealing heteromorphic plasmacyte aggregates and double immunofluorescent staining of COX2 in the plasma cells.
Figure 3: Lymph-node biopsy with hematoxylin and eosin and Ki-67 nuclear proliferation antigen staining.
Figure 4: Lymph-node biopsy and staining for vascular endothelial cells with CD34 and double immunofluorescent staining of COX2 in the plasma cells.

References

  1. Izuchukwu IS et al. (2003) An unusual presentation of Castleman's disease: a case report. BMC Infect Dis 3: 20

    Article  Google Scholar 

  2. Herrada J et al. (1998) The clinical behavior of localized and multicentric Castleman disease. Ann Intern Med 128: 657–662

    Article  CAS  Google Scholar 

  3. Menke DM et al. (2002) Analysis of the human herpesvirus 8 (HHV-8) genome and HHV-8 vIL-6 expression in archival cases of Castleman disease at low risk for HIV infection. Am J Clin Pathol 117: 268–275

    Article  Google Scholar 

  4. Gaba AR et al. (1978) Multicentric giant lymph node hyperplasia. Am J Clin Pathol 69: 86–90

    Article  CAS  Google Scholar 

  5. Oksenhendler E et al. (2002) High incidence of Kaposi sarcoma-associated herpesvirus-related non-Hodgkin lymphoma in patients with HIV infection and multicentric Castleman disease. Blood 99: 2331–2336

    Article  CAS  Google Scholar 

  6. Masferrer JL et al. (2000) Antiangiogenic and antitumor activities of cyclooxygenase-2 inhibitors. Cancer Res 60: 1306–1311

    CAS  PubMed  Google Scholar 

  7. Wang W et al. (2005) Cyclooxygenase-2 expression correlates with local chronic inflammation and tumor neovascularization in human prostate cancer. Clin Cancer Res 11: 3250–3256

    Article  CAS  Google Scholar 

  8. Su JL et al. (2004) Cyclooxygenase-2 induces EP1- and HER-2/Neu-dependent vascular endothelial growth factor-C up-regulation: a novel mechanism of lymphangiogenesis in lung adenocarcinoma. Cancer Res 64: 554–564

    Article  CAS  Google Scholar 

  9. Scott D et al. (2001) Treatment of HIV-associated multicentric Castleman's disease with oral etoposide. Am J Hematol 66: 148–150

    Article  CAS  Google Scholar 

  10. [No authors listed] (1990) Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 39-1990. A 66-year-old man with demyelinative neuropathy and a retroperitoneal mass. N Engl J Med 323: 895–908

  11. Rahme E et al. (2003) The cyclooxygenase-2-selective inhibitors rofecoxib and celecoxib prevent colorectal neoplasia occurrence and recurrence. Gastroenterology 125: 404–412

    Article  CAS  Google Scholar 

  12. Dicker AP et al. (2001) Targeting angiogenic processes by combination rofecoxib and ionizing radiation. Am J Clin Oncol 24: 438–442

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank Drs Binzhong Sun and Chuanshan Zhang for their assistance with this case study. This work was supported by the Program for New Century Excellent Talents (NCET) in University and a grant (No. 30371585) from the National Natural Science Foundation of China to Dr Jie Liu. Written consent for publication was obtained from the patient.

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Authors and Affiliations

  1. State Key Laboratory for Cancer Biology, Xijing Hospital,

    Jie Liu, Shuang Han, Jie Ding, Kaichun Wu, Jiyan Miao & Daiming Fan

  2. State Key Laboratory of Cancer Biology,

    Jie Liu, Shuang Han, Jie Ding, Kaichun Wu, Jiyan Miao & Daiming Fan

  3. Department of Digestive Diseases in Xijing Hospital, Fourth Military Medical University, Xi'an, China

    Jie Liu, Shuang Han, Jie Ding, Kaichun Wu, Jiyan Miao & Daiming Fan

Authors
  1. Jie Liu
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  2. Shuang Han
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  3. Jie Ding
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  4. Kaichun Wu
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Corresponding authors

Correspondence to Jie Liu or Daiming Fan.

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The authors declare no competing financial interests.

Glossary

SERUM–ASCITES ALBUMIN GRADIENT

A gradient calculated by subtracting the measured albumin of the ascitic fluid from the measured albumin of serum; used to determine the cause of ascites

ASTEATOSIS CUTIS

Persistent dry scaling of the skin caused by a decrease in sebaceous secretion

POEMS SYNDROME

Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes

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Liu, J., Han, S., Ding, J. et al. COX2-related multicentric mixed-type Castleman's disease in a young man. Nat Rev Clin Oncol 2, 370–375 (2005). https://doi.org/10.1038/ncponc0219

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