Bloody Minded Episode 62 - The Man in the High (Lymph Node) Castle | Castleman Disease
Sep 30, 2025
Dive into the intriguing world of Castleman disease, where the hosts break down its clinical and histological subtypes. Explore the differences between unicentric and multicentric classifications and their presentations. Learn about the critical role of HHV-8 in driving symptoms and the varied treatment options available. The discussion even touches on rarer variants like POEMS and TAFRO syndrome. Packed with insights and a touch of humor, this conversation sheds light on a complex topic that's often overlooked.
AI Snips
Chapters
Books
Transcript
Episode notes
Castleman As A Lymphoma Mimic
- Castleman disease is a lymphoma mimic that sits on the spectrum between reactive and neoplastic lymphoproliferation.
- Definitive diagnosis requires histopathology rather than clinical impressions or imaging.
Three Histologic Subtypes
- There are three histopathological subtypes: hyaline vascular, plasmacytic, and mixed, with overlapping features and contested clinical relevance.
- Pathologists must examine good excisional tissue to confirm Castleman changes and exclude clonal disease.
Always Get A Good Excisional Biopsy
- Consider Castleman when lymphadenopathy resembles lymphoma, but always pursue excisional biopsy for diagnosis.
- Remember unicentric disease usually causes local symptoms and often needs a large tissue sample for accurate histology.
