Ann Dermatol.  2011 Oct;23(Suppl 2):S169-S174. 10.5021/ad.2011.23.S2.S169.

Castleman's Disease with Cutaneous Involvement Manifestating as Multiple Violaceous Plaques on Entire Body

• Park HY
• Lee JJ
• Lee JB
• Kim SJ
• Lee SC
• Won YH
• Yun SJ

• KMID: 2156781
• DOI: http://doi.org/10.5021/ad.2011.23.S2.S169

Abstract

Castleman's disease (CD) is an uncommon B-cell lymphoproliferative disorder characterized by lymph node hyperplasia with vascular proliferation. Cutaneous involvement in CD is rare. A 65-year-old man presented with a 7-year history of gradually developing multiple reddish to violaceous indurated plaques on the scalp, trunk, and legs. On physical examination, there were palpable enlarged cervical, axillary, and inguinal lymph nodes. Laboratory examination revealed anemia, thrombocytosis, hyperproteinemia, hypoalbuminemia, and polyclonal hypergammaglobulinemia. An inguinal lymph node biopsy and a skin biopsy were performed and the patient was diagnosed with the plasma cell type of CD. Chemotherapy was started and the lesions have responded to treatment.

Keyword

Angiofollicular lymphoid hyperplasia; Castleman's disease; Giant lymph node hyperplasia; Skin

MeSH Terms

Aged
Anemia
B-Lymphocytes
Biopsy
Giant Lymph Node Hyperplasia
Humans
Hypergammaglobulinemia
Hyperplasia
Hypoalbuminemia
Leg
Lymph Nodes
Lymphoproliferative Disorders
Physical Examination
Plasma Cells
Scalp
Skin
Thrombocytosis

Figure

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  Fig. 1 Multiple reddish to violaceous indurated plaques on both flanks (A, B) and back (C).

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  Fig. 2 (A) Lymph node biopsy shows multiple follicles with vascular proliferation (H&E, original magnification ×100), (B) Many plasma cells in the interfollicular area with Russell bodies (arrow) (H&E, ×400).

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  Fig. 3 Skin biopsy shows multiple lymphoid follicles as nodular infiltration in the dermis (H&E, ×20).

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  Fig. 4 (A) Lymphoid follicles are composed of numerous lymphocytes and plasma cells (H&E, ×400). Immunohistochemical stains are positive for CD 20 (B, ×100), CD 79a (C, ×200), and bcl-2 (D, ×200).

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