ArticleFrontiers in oncology2026
Castleman disease: clinical features, pathology, and treatment outcomes in 12 cases.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To conduct a retrospective descriptive analysis of the clinical manifestations, pathological characteristics, diagnostic approaches, and treatment outcomes of Castleman disease (CD) in a Chinese regional population, thereby contributing real-world evidence to improve clinical management of this rare disorder. Methods: A retrospective analysis was performed on 12 patients with CD diagnosed via a rigorous three-step differential diagnosis protocol at Linyi People's Hospital between February 2020 and February 2024. The cohort included 10 males and 2 females, age range 20-67 years (median, 45 years). Tumor locations involved retroperitoneum, pelvis, neck, supraclavicular region, axilla, and inguinal region. According to the Frizzera classification, 7 patients were diagnosed with unicentric CD (UCD; 5 hyaline vascular type, 2 mixed type) and 5 with multicentric CD (MCD; 4 plasma cell type, 1 mixed type). All patients tested negative for HHV-8 and HIV. Treatment modalities included surgical resection alone (7 UCD cases), surgical resection followed by systemic therapy (1 MCD mixed-type case), and primary R-CHOP chemotherapy (4 MCD plasma cell type cases). Results: All 12 patients were alive at follow-up. The 7 UCD patients treated with complete surgical resection alone experienced no recurrence. The MCD mixed-type patient (Case 8) initially received rituximab for 3 months postoperatively, but interleukin-6 (IL-6) levels remained elevated; the regimen was switched to oral thalidomide-cyclophosphamide-dexamethasone (TCD) for 2 months, leading to complete remission. The 4 MCD patients treated with primary R-CHOP achieved favorable outcomes with no recurrence during follow-up (range, 10-45 months). Conclusion: In this small cohort, CD was associated with a favorable short-term prognosis following individualized treatment. Complete surgical resection is curative for resectable UCD, whereas MCD typically requires systemic therapy. In resource-limited settings where anti-IL-6 monoclonal antibodies are not readily accessible, R-CHOP represents an effective first-line alternative for idiopathic multicentric Castleman disease (iMCD), and the oral TCD regimen is a valuable option for refractory cases. These findings provide practical evidence to guide clinical decision-making for CD in regional medical centers.
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