10.5826/dpc.1302a86
text/xml
2160-9381
2659
en
Weimin Hu
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
lymphoproliferative disorders
Unicentric Castleman Disease in the Temporal Region of a Pediatric Patient
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Research Letter
2023-04-29
2022-06-17
2023-04-29
2023-06-05
e2023086
Dermatol Pract Concept
Weimin Hu
2023/04/29
10.5826/dpc.1302a86
e2023086
Kansas City University (KCU-GMEC) Phoenix Dermatology, Specialists in Dermatology, Tucson, AZ, United States
2160-9381
lymphoproliferative disorders
en
e2023086
Talat N, Belgaumkar AP, Schulte KM. Surgery in Castleman's disease: a systematic review of 404 published cases. Ann Surg. 2012 Apr;255(4):677-84. DOI: 10.1097/SLA.0b013e318249dcdc. PMID: 22367441.
Unicentric Castleman Disease in the Temporal Region of a Pediatric Patient
https://dpcj.org/index.php/dpc/article/download/2659/2060
        Unicentric Castleman Disease in the Temporal
                Region of a Pediatric Patient
               Jeffrey Dickman1, Samantha Haraszti1, Karen Warschaw1,2, Weimin Hu1,3


1 Kansas City University (KCU-GMEC) Phoenix Dermatology, Phoenix, Arizona, United States
2 Sonic Healthcare USA, Arizona Dermatopathology, Scottsdale, Arizona, United States
3 Specialists in Dermatology, Tucson, Arizona, United States



Key words: Castleman disease, pediatric, temple, lymphoproliferative disorders
Citation: Dickman J, Haraszti S, Warschaw K, Hu W. Unicentric Castleman Disease in the Temporal Region of a Pediatric Patient.
Dermatol Pract Concept. 2023;13(2):e2023086. DOI: https://doi.org/10.5826/dpc.1302a86
Accepted: September 13, 2023; Published: April 2023
Copyright: ©2023 Dickman et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Jeffrey Dickman, DO, 4801 E McDowell Rd, STE 150, Phoenix, Arizona 85008, United States. 602-954-3919
E-mail: jstdickman@gmail.com




Introduction                                                             laminations resulting in an “onion-skin appearance,” and
                                                                         penetrating hyalinized arterioles (Figure 1). Immunohisto-
Castleman disease (CD) encompasses a group of rare lymph-                chemistry demonstrated CD20 and PAX-5 positive B cells
oproliferative disorders with common histopathologic fea-
tures. The most common subtype is unicentric CD (UCD)
which involves a single region of enlarged lymph nodes. CD
can occur in any lymph node; however, CD has a predilec-
tion for the mediastinum, and rarely presents on the face [1].
Here we report a case of UCD presenting in the temporal
region of a pediatric patient.


Case Presentation
An 11-year-old female presented for excisional biopsy of an
enlarging mass on the right temple which had been present
for 17 months and was occasionally tender. An MRI revealed
a well-circumscribed 3.4 cm x 1.4 cm x 3 cm soft tissue mass
lateral to the temporalis muscle.
                                                                         Figure 1. Lymphoid tissue with atretic and hyalinized germinal cen-
    Histological analysis of the specimen revealed lymphoid              ters, concentric laminations resulting in an “onion-skin ­appearance,”
tissue with atretic and hyalinized germinal centers, concentric          and penetrating hyalinized arterioles (H&E, 40x).



Research Letter | Dermatol Pract Concept. 2023;13(2):e2023086                                                                               1
within the germinal centers, as well as CD21 positive fol-       UCD in the chest or abdominal cavities. In a systematic re-
licular dendritic cells forming a laminated meshwork and         view of 278 UCD cases, 249 had surgical resection alone,
occasionally merging with neighboring germinal centers.          and 13 had combination surgical and immunosuppressive
These findings in a single region, along with the absence of     treatments with a 5-year disease free recurrence rate of ap-
prominent plasmacytosis, atypical lymphocytes, and large or      proximately 81% and a 10-year survival rate of approxi-
transformed lymphoid populations are consistent with the         mately 95%. Continued follow-up is essential to monitor for
features of UCD.                                                 recurrences. Treatment of MCD is more complex and the
                                                                 prognosis is generally worse with a 10-year survival rate of
                                                                 approximately 67% [5].
Conclusions                                                         There have been two other case reports of CD presenting
                                                                 in the temporal region [1,3]. This case is unique given the
CD is categorized into two groups: unicentric and mul-
                                                                 presentation of temporal UCD in a pediatric patient. Derma-
ticentric. UCD involves a single region of enlarged lymph
                                                                 tologists should be aware that CD may develop in this region
nodes and is more common than multicentric CD (MCD).
                                                                 in both children and adults.
MCD affects multiple lymph node regions and usually
presents with systemic symptoms or laboratory abnormal-
ities demonstrating chronic inflammation such as elevated        References
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                                                                    Castleman’s Disease in the Temporal Region: A Case Report
an incidental finding on imaging or physical examination;           Involving a Young Korean Woman and Review of the Litera-
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                                                                 5. Talat N, Belgaumkar AP, Schulte KM. Surgery in Castleman's
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