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Elderly adults present with B symptoms (i.e. fever, night sweats, and weight loss), swollen lymph nodes, and symptoms due to malignant cell infiltrations into the upper gastrointestinal tract, lungs, upper airways, and/or other organs. Younger individuals present with swollen lymph nodes but frequently do not have class B symptoms or ...
Idiopathic multicentric Castleman disease (iMCD) is a subtype of Castleman disease (also known as giant lymph node hyperplasia, lymphoid hamartoma, or angiofollicular lymph node hyperplasia), a group of lymphoproliferative disorders characterized by lymph node enlargement, characteristic features on microscopic analysis of enlarged lymph node tissue, and a range of symptoms and clinical findings.
Castleman disease (CD) can involve one or more enlarged lymph nodes in a single region of the body (unicentric CD, UCD) or it can involve multiple enlarged lymph node regions (multi centric CD, MCD). [4] Doctors classify the disease into different categories based on the number of enlarged lymph node regions and the underlying cause.
However, inguinal lymph nodes of up to 15 mm and cervical lymph nodes of up to 20 mm are generally normal in children up to age 8–12. [ 38 ] Lymphadenopathy of more than 1.5–2 cm increases the risk of cancer or granulomatous disease as the cause rather than only inflammation or infection .
[3] [13] [14] Diagnosis, if enlarged lymph nodes are present, is usually by lymph node biopsy. [1] [2] Blood, urine, and bone marrow testing may also be useful in the diagnosis. [2] Medical imaging may then be done to determine if and where the cancer has spread. [1] [2] Lymphoma most often spreads to the lungs, liver, and brain. [1] [2]
Symptoms can include swollen but painless lymph nodes, unexplained fever, and unintended weight loss. [2] There are several subtypes, the most common of which is follicular lymphoma. Others include cutaneous T-cell lymphoma, marginal zone lymphoma, chronic lymphocytic leukemia, and Waldenström macroglobulinemia. [2]
[29] [30] Lymph node staging depends on the extent of local spread: with the cancer metastasized to no lymph nodes (N0), pulmonary or hilar nodes (along the bronchi) on the same side as the tumor (N1), mediastinal or subcarinal lymph nodes (in the middle of the lungs, N2), or lymph nodes on the opposite side of the lung from the tumor (N3). [30]
Duration of symptoms can vary, and ranges between weeks to months following initial onset. [1] Unilateral lymph node involvement accounts for the majority of cases, and involvement of the cervical lymph nodes is the most common. [1] In addition to swollen lymph nodes, the person may experience mild fevers, decreased appetite, or weight loss. [5]