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Y.D. Kim



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    P2.24 - Poster Session 2 - Supportive Care (ID 157)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P2.24-018 - Primary mediastinal Castleman' disease; Surgically curable anemia : A case report (ID 1268)

      09:30 - 09:30  |  Author(s): Y.D. Kim

      • Abstract

      Background
      Castleman’s disease, an uncommon disease that causes benign lymph node hyperplasia, must be distinguished from reactive lymph node hyperplasia and malignancies. Unicentric Castleman’s disease in patients with anemia is rarely described.

      Methods
      We describe the case of a 25-year-old woman with plasma cell type of unicentric Castleman’s disease presenting as iron deficiency anemia. We report the clinical course from the initial presentation to diagnosis and surgical cure and review the literature.

      Results
      Figure 1 A 25-year-old woman was referred with abnormal chest X-ray which was found during pre-employment screening. She had no other complaints, and her previous medical history was unremarkable, as was her family medical history. No fever, acute infectious symptoms and signs, or any other abnormalities were found in the physical examination. Normocytic anemia was found based on initial blood tests (hemoglobin 7.7 g/dl, mean corpuscular volume 88.9 fl, with normal white blood cells, red blood cell distribution width, liver renal functions, and electrolytes). Further laboratory examinations (ferritin 89.0 ng/ml; serum iron 23 mg/dl; and total iron binding capacity 206 mg/dl) demonstrated that she was iron deficient. Chest X-ray and chest CT scan confirmed a mass (6x4x4 cm) at right superior and mid-mediastinum (Fig. 1). PET/CT showed paratracheal mass shows inhomogeneously high FDG uptake. In suspicion of lymphoma, diagnostic thoracoscopic surgery was planned. However, intraoperative frozen section diagnosis of a specimen was benign. Thus, the mass was completely removed and diagnosis was consistent with unicentric plasma cell type Castleman’s disease. Three months after surgery, without any medical intervention, the laboratory data had recovered to normal range (hemoglobin 14.5 g/dl). She receives regular follow ups and no recurrence has been found for 4 years since surgery.

      Conclusion
      The surgical resection would appear to be the optimal treatment modality, and constitutional symptoms may be resolved. The prognosis following complete surgical resection appears to be good.