ICH Study Center Hamburg, Hamburg, Germany.
II. Department of Medicine, University of Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Oncol Res Treat. 2022;45(11):693-704. doi: 10.1159/000526640. Epub 2022 Oct 11.
Castleman disease (CD) encompasses a spectrum of rare disorders with characteristic histopathological features. Unicentric CD (UCD) is a benign, local hyperplasia of lymphoid tissue that is usually curable. Multicentric CD (MCD) manifests as a potentially life-threatening systemic disease with complex symptomatology which is mostly due to an overproduction of interleukin-6 (IL-6) or dysregulation of IL-6-related signaling pathways. From a therapeutic perspective, it is important to distinguish idiopathic MCD (iMCD) from those cases that are associated with the human herpesvirus-8 (HHV-8 + MCD).
During recent years, it has become increasingly clear that even HHV-8-negative MCD is not a homogeneous entity and that there are clinically distinct variants. International consensus guidelines for diagnosis and treatment have been developed for iMCD and UCD.
We herein summarize recent advances in diagnosis, treatment, and novel insights into the pathogenesis of this disease.
Castleman 病(CD)包括一系列具有特征性组织病理学特征的罕见疾病。局灶性 Castleman 病(UCD)是一种良性的局部淋巴组织增生,通常可以治愈。多中心 Castleman 病(MCD)表现为一种潜在危及生命的全身性疾病,其复杂的症状主要是由于白细胞介素-6(IL-6)的过度产生或 IL-6 相关信号通路的失调所致。从治疗的角度来看,区分特发性 MCD(iMCD)和与人类疱疹病毒-8(HHV-8+MCD)相关的 MCD 非常重要。
近年来,人们越来越清楚地认识到,即使是 HHV-8 阴性的 MCD 也不是一个同质的实体,而是存在临床上明显不同的变体。已经为 iMCD 和 UCD 制定了国际诊断和治疗共识指南。
我们在此总结了该疾病在诊断、治疗和发病机制方面的最新进展。