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


METHODS
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.


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


RESULTS
Chemotherapy and COX2 inhibitors.
Liu
Jie
J
State Key Laboratory for Cancer Biology, Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China. jieliu@fmmu.edu.cn
Han
Shuang
S
Ding
Jie
J
Wu
Kaichun
K
Miao
Jiyan
J
Fan
Daiming
D
D000328:Adult; D005871:Castleman Disease / Q000188:drug therapy* / Q000201:enzymology* / Q000473:pathology; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008565:Membrane Proteins; D011451:Prostaglandin-Endoperoxide Synthases / Q000032:analysis* / Q000502:physiology
D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases