title: [Multicentric hyaline vascular Castleman's disease. A POEMS type variant].
abstract: BACKGROUND
  Castleman's disease is an atypical lymphoproliferative disorder which may be compatible with paraneoplastic manifestations of POEMS syndrome.
  
  
  METHODS
  a 53 year old man with a history of type 2 diabetes, hypothyroidism and Addison's disease presented with numbness and weakness in limbs, dyspnea, skin hardening, Raynaud's phenomenon, weight loss and fatigue. A physical exam showed tachypnea, generalized cutaneous hyperpigmentation and skin hardening of extremities, muscle weakness, hypoesthesia and hyporeflexia. Laboratory showed hyperprolactinemia, low testosterone, hypothyroidism and Addison's disease. Electrophoresis of proteins showed polyclonal hypergammaglobulinemia. Somatosensory evoked potentials reported peripheral neuropathy and severe axonal polyneuropathy by electromyography. Chest X-rays showed bilateral reticular infiltrates and mediastinal widening. An echocardiogram displayed moderate pulmonary hypertension. Skin biopsy had no evidence of scleroderma. CT reported axillar, mediastinal and retroperitoneal nodes. The mediastinal lesion biopsy reported hyaline vascular Castleman's disease, multicentric variety. He was treated with rituximab.
  
  
  CONCLUSIONS
  the case meet criteria for multicentric hyaline vascular Castleman's disease, POEMS variant, treated with rituximab.
authors.affiliation: Instituto Mexicano del Seguro Social, Distrito Federal, Mexico. ken_monsters@hotmail.com
authors.forename: Abraham Edgar
authors.initials: AE
authors.lastname: Gracia-Ramos
authors.forename: María del Pilar
authors.initials: Mdel P
authors.lastname: Cruz-Domínguez
authors.forename: Olga Lidia
authors.initials: OL
authors.lastname: Vera-Lastra
mesh_terms: D005871:Castleman Disease / Q000145:classification / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000145:classification / Q000175:diagnosis*
keywords: POEMS syndrome; giant lymph node hyperplasia; hiperplasia de ganglio linfático gigante; síndrome POEMS