Castleman’s disease is a rare illness of lymph nodes. It is also associated with an increased risk of developing certain forms of cancer.
The cause of this disease is not clear. It was discovered that there is an excessive proliferation of certain white blood cells known as B- lymphocytes. These cells then occupy lymph nodes in our body. Most often affected are neck, chest and abdominal lymph nodes. Numerous white blood cells can product a large number of aggressive substances that can cause symptoms typical for a chronic inflammatory process.
The disease has two basic forms. First form has only one lymph node affected and it has a better prognosis. The second form is associated with affection of multiple lymph nodes al over the body. The lymph nodes are painlessly swollen and symptoms of inflammation occur like fever, weight loss, loss of appetite and fatigue. There is usually a decrease in red blood cell production with subsequent anemia. This form invading more nodes can turn into a malignant lymphoma and is also present by about 10 % of patients with Kaposi's sarcoma.
Enlarged lymph nodes are often palpable, especially when not deep under the skin. Deeper located nodes can be viewed by using imaging techniques such as ultrasound, computed tomography or more sophisticated methods available (PET CT examination). Diagnostic approach should also lead to a surgical extraction of a suitable lymph node and its histological examination.
The form with a single affected node has an excellent prognosis and removal of this lymph node usually leads to complete cure. For forms with multiple infiltrated nodes there is no effective form of treatment and patients’ prognosis is overall poor. Chemotherapy, radiation therapy and biological therapy have been tried with mixed results.