Successful immunomodulatory therapy in castleman disease with paraneoplastic pemphigus vulgaris

Zsofia Miltenyi, J. Tóth, Andrea Gonda, Ildiko Tar, E. Remenyik, A. Illés

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Castleman disease is a rare lymphoproliferative disorder. The clinical signs and symptoms of the disease are primarily mediated by cytokines, especially interleukin-6. We presented the case of a young female. In May 2004, a 30-year-old otherwise healthy looking woman presented with oral ulcerations resistant to topical and systemic antibiotic and antimycotic treatment. Bullous mucosal lichen or pemphigus vulgaris were suspected. Histological examination and direct and indirect immunofluorescence confirmed the diagnosis of pemphigus. Search for neoplasm revealed a retroperitoneal Castleman tumour sized 15×6×5 cm in the abdominal MRI. The tumour was a bleeder, so the removal was partial. Histological examination showed hyalin hypervascular Castleman disease. Considering her young, fertile age and the multicentric Castleman disease, non-cytostatic immunomodulatory therapy was started including steroid, cyclosporine-A and thalidomide treatment. The control abdominal CT showed a small residual tumour on the bladder. The residual tumour was removed in repeated surgery. At this time the histological examination showed transient type tumour between plasma cell and vascular variant. Currently, i.e. 4 years after the onset of the disease. 18FDG PET/CT examination showed low metabolic active mass in the right iliacal region, but our patient had no symptoms or complaints. She is on 200 mg thalidomide a day and no tumour progression can be seen. Castleman disease can be successfully treated with non-cytostatic immunomodulatory therapy.

Original languageEnglish
Pages (from-to)375-381
Number of pages7
JournalPathology and Oncology Research
Volume15
Issue number3
DOIs
Publication statusPublished - Sep 2009

Fingerprint

Giant Lymph Node Hyperplasia
Pemphigus
Immunomodulation
Thalidomide
Residual Neoplasm
Neoplasms
Direct Fluorescent Antibody Technique
Lichens
Hyalin
Plasmacytoma
Lymphoproliferative Disorders
Fluorodeoxyglucose F18
Indirect Fluorescent Antibody Technique
Cyclosporine
Signs and Symptoms
Blood Vessels
Interleukin-6
Urinary Bladder
Steroids
Cytokines

Keywords

  • Castleman disease
  • Immunmodulatory
  • PET/CT

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pathology and Forensic Medicine

Cite this

Successful immunomodulatory therapy in castleman disease with paraneoplastic pemphigus vulgaris. / Miltenyi, Zsofia; Tóth, J.; Gonda, Andrea; Tar, Ildiko; Remenyik, E.; Illés, A.

In: Pathology and Oncology Research, Vol. 15, No. 3, 09.2009, p. 375-381.

Research output: Contribution to journalArticle

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