Özgür ÖZYILKAN, N. Emrah KOÇER, Fatih KÖSE, Ayberk BESEN, Hüseyin MERTSOYLU, Ahmet SEZER

Human Immune Deficiency Virus Infection, Multicentric Castleman's Disease and, Non-Hodgkin's Lymphoma: Diagnosed simultaneously as One Disease

Castleman hastalığı ilk kez 1954 yılında Benjamin Castleman tarafından fark edilmiş ve yayınlanmıştır. Castlemanhastalığı multisentrik veya lokalize form olarak iki şekilde prezente olabilir. Multisentrik Castleman hastalığı dahaönceki zamanlarda altıncı veya yedinci dekadda görülürken AIDS hastalığının yaygınlaşması sonrası daha erken yaş- larda görülmeye başlanmıştır. HIV enfeksiyonu ve multisentrik Castleman hastalığı arasındaki ilişki uzun zaman- dır bilinmektedir. Multisentrik Castleman hastalığı ve HIV birlikteliği Hodgkin dışı lenfoma için kuvvetli bir pre- dispozan faktördür. Bu hastalarda hodgkin dışı lenfoma tanısı genelde HIV enfeksiyonu için hasta izlemde iken ko- nulur. Sunulan vaka dispepsi ve kilo kaybı ile kliniğimize başvurmuş, panendoskopi ile malin gastrik lenfoma tanı- sı konmuş. Fizik muayenesinde bulunan aksiller lenf nodundan alınan biyopsi sonucu ile hiyalen vasküler tip Cast- leman hastalığı tanısı konulmuştur. Hastada laboratuvar değerlendirmesinde HIV pozitifliği saptanmıştır. Bu vaka- mızla aynı anda gastrik lenfoma, Castleman hastalığı ve HIV pozitifliği bulunan ender bir hastanın yönetimini tartış- mak ve paylaşmak istedik.

Non-Hodgkin Lenfoma, İnsan Bağışıklık Eksikliği Virüsü (HIV) Enfeksiyonu ve Multisentrik Kastleman Hastalığı: Tek Hastalık Olarak Prezentasyonu

Castleman's disease was first recognized by Benjamin Castleman at 1954 and published as a case record. Castle- man's disease can present as a localized or multicentric form. Although Multicentric Castleman's disease(MCD) isusually seen in the 6th or 7th decades, after AIDS pandemic MCD started to be seen at earlier decades. HIV infectionis known to be causally linked to MCD. Also patients with HIV infection are at increased risk for developing Non- Hodgkin's lymphoma(NHL) and when HIV infection is found with MCD, risk of NHL is much greater. Usually thepatients were discovered as NHL while followed with diagnosis HIV infection and MCD. The patient had complaintof dyspepsia and weight loss. Panendoscopy was performed and biopsy of malignant appeared gastric ulcer revealeddiagnosis of malignant lymphoma. Right axillary biopsy was carried out with diagnosis of Hyalen Vascular typeCastleman's disease. The patient was HIV positive. So we reported a case that simultaneously diagnosed as gastriclymphoma, MCD and HIV positivity.

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1. Castleman B, Towne VW. Case records of the Massachusetts Gen- eral Hospital: Case No. 40231. N Engl J Med, 1954; 250,1001-5. 2. Waterston A, Bower M. Fifty years of multicentric Castlemans disease. Acta Oncol.2004;43,698704. 3. Lachant NA, Sun NC, Leong LA, et al. Multicentric angiofollicular lymph node hyperplasia ( Castleman's Disease) followed by Ka- posi's sarcoma in two homosexual males with the acquired immu- nodeficiency syndrome(AIDS). Am J Clin Pathol.1985;83,27-33. 4. Levine AM. AIDS-related malignancies. Curr Opin Oncol,1994; 6,489. 5. Cote Tr. Biggar, RJ, Rosenberg PS, et al. Non-hodgkin's lym- phoma among people with AIDS: Incidence, presentation and public health burden. AIDS/Cancer Study Group. Int J Can- cer,1997;73,645. 6. Sandler AS, Kaplan LD. Diagnosis and management of system- ic non-Hodgkin's lymphoma in HIV. Hematol Oncol Clin North Am,1996; 10,1111. 7. Gessain A, Sudaka A, Briere J, et al. Kaposi's sarcoma-associated herpes like virus (HHV-8) DNA sequences in multicentric castle- man's CD: ıs there any relevant association in non-human immu- nodeficiency virus-infected patients? Blood. 1996; 87,414. 8. Casper C. New approaches to the treatment of Human Herpesvirus 8- associated disease. Rev med Virol. 2008:18, 321-329. 9. Oksenhendler E, Boulanger E, Galicier L, et al .High incidence of Kaposi sarcoma- associated-related non- Hofgkin lymphoma in patients with HIV infection and multicentric Castleman's disease. Blood, 2002,;99,2331-2335. 10. Mylona EE, Baraboutis IG, Lekakis LJ, Georgiou O, Papasta- mopoulos V, Skoutelis A. Multicentric Castleman's disease in HIV infection: a systematic review of the literature. AIDS rev. 2008; 10, 25-35. 11. Powles T, Stebbing J, Bazeos A, Hatzimichael E, Mandalia S, Nel- son M, Gazzard B, Bower M. The role of immune suppression and HHV-8 in the increasing incidence of HIV-associated multicentric Castleman's disease. Ann Oncol. 2009;20, 775-9. 12. Dayyanı F, Pantanowitz L, Sandridge TG, et al. Multicentric Cas- tleman's disease masquerading as HIV-related lymphoma. Am J Med Sci,2007;334,317-319.