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Tests and diagnosis
By Mayo Clinic staffA number of tests can help your doctor determine if you have Castleman disease, although unicentric Castleman disease may be found incidentally. People with unicentric Castleman disease often notice no symptoms, and the diseased lymph node is found during screening or treatment for another illness, such as during a CT scan or during abdominal or chest surgery.
Tests your doctor may conduct to diagnose either unicentric or multicentric Castleman disease include:
- Physical examination. Your doctor may examine not only your swollen lymph nodes but also your other lymph nodes to determine their size and consistency.
- Blood and urine tests. Blood and urine tests may help your doctor rule out other infections or diseases. They can also reveal anemia and abnormalities in blood proteins that are sometimes characteristic of Castleman disease.
- Imaging techniques. An X-ray, computerized tomography (CT) scan or magnetic resonance imaging (MRI) scan of your chest, neck, abdomen and pelvis may detect the presence and number of enlarged lymph nodes. These tests can also determine whether organs, such as your liver or spleen, are enlarged. Positron emission tomography (PET) scans also may be used in diagnosing Castleman disease and later, to assess whether a treatment is working.
- Lymph node biopsy. To differentiate Castleman disease from other types of lymphatic tissue disorders, such as lymphoma, it's necessary to take a sample of lymph node tissue for examination in the laboratory. If the enlarged lymph node is close to the surface of your skin, the biopsy can be done under local anesthesia. If it's in your chest or abdomen, more extensive surgery may be necessary to access the lymph node. By looking at the structure of the cells, a doctor who specializes in diagnosing disease (pathologist) may be able to tell whether it's lymphoma or Castleman disease. Because Castleman disease is rare, a second pathologist may be needed to confirm the diagnosis.
References
- Aster JC, et al. Castleman's disease. http://www.uptodate.com/home/index.html. Accessed July 19, 2011.
- Castleman disease. American Cancer Society. http://www.cancer.org/acs/groups/cid/documents/webcontent/003093-pdf.pdf. Accessed July 19, 2011.
- About Castleman's disease. International Castleman's Disease Organization. http://www.castlemans.org/ICDO_booklet_v3.pdf. Accessed July 19, 2011.
- Pica F, et al. Transmission of human herpesvirus 8: An update. Current Opinion in Infectious Diseases. 2007;20:152.
- Bandera B, et al. Treatment of unicentric Castleman disease with neoadjuvant rituximab. Chest. 2010;138:1239.
- Reddy D, et al. HIV-associated multicentric Castleman disease. Current Opinion in Oncology. In press. Accessed [month day, 2011]. Accessed July 19, 2011.
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