Unicentric Castleman Disease: Updates and Novel Insights Into Spindle Cell Proliferations and Aggressive Forms of a Localized Disease

Int J Lab Hematol. 2025 Feb;47(1):26-35. doi: 10.1111/ijlh.14395. Epub 2024 Nov 5.

Abstract

Castleman Disease (CD) is a rare lymphoproliferative disorder that can be separated into two primary forms: Unicentric Castleman disease (UCD) and multicentric Castleman disease (MCD). UCD is localized, while MCD is systemic. Though UCD generally has a favorable prognosis following surgical resection, more aggressive forms of this disease have been identified, including cases associated with dendritic and spindle cell proliferation. Genetic analysis has deepened our understanding of UCD. Despite advancements in better understanding the pathophysiology of UCD, challenges persist in the diagnosis, management, and treatment due to its rarity and heterogeneity. Here, we review current knowledge on UCD, highlighting the epidemiology, clinical presentation, diagnostic criteria, and treatment options while emphasizing the need for further research and innovation in therapeutic strategies.

Keywords: Castleman disease; IgG4 related disease; Interleukin‐6; PDGFRB; follicular dendritic cells; idiopathic multicentric Castleman disease; unicentric Castleman disease.

Publication types

  • Review

MeSH terms

  • Castleman Disease* / diagnosis
  • Castleman Disease* / pathology
  • Castleman Disease* / therapy
  • Cell Proliferation
  • Humans
  • Prognosis