Article

Localised hyaline vascular type of Castleman's disease mimicking adult-onset Still's disease

Department of Pediatrics, Chang Gung Children's Hospital, Kweishan, Taoyuan, Taiwan.
Clinical Rheumatology (Impact Factor: 1.77). 02/1999; 18(6):485-7. DOI: 10.1007/s100670050143
Source: PubMed

ABSTRACT A previously healthy 18-year-old boy presented with daily spiking fever, polyarthritis, and evanescent skin rashes, as well as hepatomegaly and Raynaud's phenomena for 2 months. He was initially diagnosed with adult-onset Still's disease (AOSD). During the period of follow-up, intermittent fever and migratory polyarthritis persisted and an insidiously growing mass over the right axillary region was noted 1 year after the diagnosis of AOSD. Excisional biopsy of the mass revealed a group of lymph nodes with histological features of the hyaline vascular type of Castleman's disease. The patient's symptoms disappeared soon after excision of the lymph nodes. evanescent rash, lymphadenopathy, hepatosplenomegaly and serositis [5]. A clinical picture compatible with the diagnosis of AOSD has not been described in the localised hyaline vascular type of Castleman's disease. We report such a case in an 18-year-old male patient who presented prolonged fever and polyarthritis with an initial diagnosis of AOSD. The diagnosis of hyaline vascular type of Castleman's disease was made 1 year later, when the patient developed an insidiously growing mass over the right axilla.

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    • "The diagnosis of CD in these cases is surprising clinically. On the other hand, due to the histopathological similarities CD may mimic some collagen vascular diseases or in some cases, autoimmune disorders and pathological findings of some reactive lymphoid hyperplasias may mimic CD [15] [16] [17] [18]. So CD may cause some difficulties in some situations in rheumatology clinics. "
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