J Korean Soc Transplant.  2019 Mar;33(1):13-18. 10.4285/jkstn.2019.33.1.13.

A case of Castleman disease that improved after kidney transplantation

• Lee HR
• An JM
• Lee DR
• Choi HW
• Oh JS
• Kim JK

• KMID: 2442598
• DOI: http://doi.org/10.4285/jkstn.2019.33.1.13

Abstract

This is a case of a 56-year-old man with Castleman disease (CD) who improved after kidney transplantation (KTP). CD is an uncommon lymphoproliferative disorder that was found incidentally on biopsy during dialysis in the current patient and was followed up without further treatment. However, the lesion showed improvement after KTP. Therefore, active KTP can be considered even if CD is one of the lymphoproliferative disorders that can occur as a complication after KTP.

Keyword

Castleman disease; Kidney transplantation; Hemodialysis

MeSH Terms

Biopsy
Dialysis
Giant Lymph Node Hyperplasia*
Humans
Kidney Transplantation*
Kidney*
Lymphoproliferative Disorders
Middle Aged
Renal Dialysis

Figure

• 

  Fig. 1 Abdominopelvic computed tomography scan showed multiple, variable-sized, and homogeneously enhanced nodular densities in the paraaortic (A, solid arrows) and mesenteric (B, open arrows) regions. Although not shown here, retrocaval and inguinal regions were also observed.

• 

  Fig. 2 Light-microscopy inguinal biopsy findings (H&E). (A) The follicle size varied due to abnormally large germinal centers (×10). (B) The interfollicular region was hypervascular and contained plasma cell sheets. Increased vascularity was observed in high-endothelial venules located at interfollicular zones (×200).

• 

  Fig. 3 (A) Abdominopelvic computed tomography (CT) scan before kidney transplantation. Compared with the previous CT scan (Fig. 1), the size became larger (solid arrows). (B) CT scan conducted 3 weeks after kidney transplantation showed a decreased lymph-node size compared with the previous CT scan (open arrows). (C) CT scan conducted 1 year after kidney transplantation showed that the size and number of lymph nodes remained unchanged (arrowheads).

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  Fig. 4 (A) Chest computed tomography (CT) scan before kidney transplantation. Multiple enlarged mediastinal and hilar lymph nodes were detected, especially in the axillary lymph nodes (solid arrow). (B) The lymph node size in the CT scan at 3 weeks after kidney transplantation was smaller than that in the previous CT scan (open arrow).

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