ABSTRACT
Castleman's disease is a disorder of the lymph nodes that encompasses heterogeneous clinical conditions and can be classified into two main types - hyaline vascular and plasma cell. The affected age group ranges widely from two to 80 years old at the time of diagnosis, with a variable clinical presentation. The etiology of Castleman's disease is not yet well-understood; however, a number of factors have been linked to its pathogenesis including certain cytokines, viral infections, autoimmunity, immunodeficiency, chronic inflammation, and Kaposi sarcoma. In this study, we present a case of a 52-year-old Saudi female with a history of pulmonary embolism and deep venous thrombosis, who was then found to have mild splenomegaly, mediastinal, bilateral hilar, supraclavicular, paraaortic, and right axillary lymphadenopathy on CT scan, to be later diagnosed as a multicentric Castleman's disease (MCD). Moreover, the clinical picture, pathogenesis, clinical and histological variants, as well as the treatment options of MCD are discussed.
ABSTRACT
OBJECTIVES: To evaluate the clinical presentations and immunohistochemical (IHC) properties of gastrointestinal stromal tumors (GISTs) and to compare them to internationally published data. METHODS: Thirty-six patients diagnosed with GISTs between January 1997 and December 2015 were retrospectively studied in 2 tertiary hospitals. Immunohistochemical staining was carried out prospectively when it has not been completed fully at the beginning. Results: The median age of patients was 54 years (range; 17-81 years). Predominantly, we found more females were affected. The male to female ratio was 1:1.7. The most frequently affected organs were the stomach (63.8%) followed by small bowel (25%) and colorectal region (8.4%). Abdominal pain was the most frequent presentation in 33.3% of the patients then gastrointestinal (GI) bleeding in 30.5%. Most of the gastric GISTs were at early stages at presentation: stage 1 and II (60.8%), while in non-gastric GISTs, the tumor stage was advanced: stage III and IV (69.3%). The IHC characteristic of GIST in descending order showed positivity for vimentin (88.9%), CD117 (83.3%), CD34 (77.8%), Ki67 (63.9%), SMA (38.9%), desmin (27.8%), and S100 (19.4%). CONCLUSION: Gastrointestinal stromal tumors in our study demonstrates a major similar feature as the published international data. However, minor differences do exist in terms of clinical features and immunohistochemistry.
