title: [Hyaline-vascular Multicentric Castleman's Disease in an immunocompetent patient].
abstract: A previously healthy, immunocompetent 67-year-old female presented with a one-month history of general symptoms, weight loss, night fevers, and bilateral lower extremity edema. On admission she had severe anemia, acute kidney injury, and multiple lymphadenopathies. An excisional biopsy of one of the axillary lymphadenopathies confirmed hyaline-vascular Castleman's disease. This rare disease is a polyclonal lymphoproliferative disorder that affects the normal lymph node architecture. According to its location it can be divided in unicentric (localized) or multicentric disease; it can be further divided according to histopathology in hyaline-vascular or plasmatic cells variety. Clinical presentation relates more to histopathological variety than to centricity. Human herpes virus 8 is ubiquitous in this disease and, along with interleukin 6, plays an important role in pathogenesis and symptoms presentation. Surgery is the go-to treatment of localized disease, while systemic chemotherapy is the option in multicentric disease. Communication between the clinical and anatomopathological teams is crucial; lag in diagnosis can lead to futile investigations in search of other diseases and delay in treatment.
authors.affiliation: División de Medicina Interna, Hospital General Dr. Manuel Gea González México, D.F., México.
authors.forename: Sergio Armando
authors.initials: SA
authors.lastname: Zapata-Bonilla
authors.affiliation: División de Medicina Interna, Hospital General Dr. Manuel Gea González México, D.F., México.
authors.forename: Roberto
authors.initials: R
authors.lastname: López Vargas
authors.affiliation: División de Medicina Interna, Hospital General Dr. Manuel Gea González México, D.F., México.
authors.forename: Aldo Alfonso
authors.initials: AA
authors.lastname: Scherling-Ocampo
authors.affiliation: División de Anatomía Patológica, Hospital General Dr. Manuel Gea González México, D.F., México.
authors.forename: Ana Lilia
authors.initials: AL
authors.lastname: Morales Leyte
authors.affiliation: División de Anatomía Patológica, Hospital General Dr. Manuel Gea González México, D.F., México.
authors.forename: Liliana
authors.initials: L
authors.lastname: García Ilizaliturri
mesh_terms: D000368:Aged; D005871:Castleman Disease / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D003967:Diarrhea / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D015785:Eye Diseases, Hereditary / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D007121:Immunocompetence; D007410:Intestinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012868:Skin Abnormalities / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D014652:Vascular Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy