This book describes Castleman Disease, Diagnosis and Treatment and Related Diseases

Castleman disease is an infrequent disorder that happens when too many cells proliferate in the lymph nodes, the small organs that filter out pathogens.

After a while, hard growths of lymph nodes form.

There is an overgrowth of cells in the body's lymphatic system.

Castleman disease can involve one or more lymph nodes in a single area of the body or it can involve multiple lymph node areas.

Types of Castleman Disease

Castleman disease happens in 1 of 2 ways.

1. Unicentric Castleman disease (UCD) involves one group of lymph nodes, often in the chest or abdomen.

It is the most frequent form.

This form involves a single or multiple lymph nodes in one area of the body.

It is also termed localized Castleman disease.

The precise cause of UCS is not clear.

Surgery to eliminate those lymph nodes normally cures it.

2. Multi-centric Castleman disease (MCD) is the other form.

It involves many lymph nodes.

Since it is so widespread, doctors cannot eliminate all of the involved nodes the way they can with UCD.

In this form, multiple lymph node areas in the body are affected.

About half of MCD cases are produced by HHV-8 infection in people with human immunodeficiency virus (HIV) or otherwise immunocompromised for other causes.

The remaining half of MCD cases are HHV-8 negative and are indicated as HHV-8 negative MCD or idiopathic MCD or iMCD.

iMCD can be further categorized intro 3 distinct medical groups:

a. iMCD linked with POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal plasma cell disorder and Skin changes)

b. iMCD linked with TAFRO (Thrombocytopenia, Anasarca, Myelofibrosis, Renal dysfunction and Organomegaly)

c. iMCD, not otherwise specified (iMCD-NOS)

Medicines can manage these iMCD groups and keep it under control.

Microscopic subtypes of Castleman disease

There are also 4 subtypes, categorized by how the lymph tissue looks under a microscope.

1. Hyaline vascular type
This is the most frequent form.
It is normally in one region.
The patient probably does not have many symptoms.

2. Plasma cell type
This tends more likely to be multicentric and to produce symptoms.

3. Mixed type
This has regions of both hyaline vascular and plasma cell types.

4. Plasmablastic type
This is normally multicentric and produces symptoms.

An infection such as human herpes virus 8 (HHV-8) and possibly others and disorders with the body's immune system may induce Castleman disease.

Castleman disease may be linked with other cancers such as lymphoma.

Castleman disease involves the same numbers of males and females.

It can happen at any age group.

The precise cause is not clear.

It might affect disorders in the immune system, the body's main defense against germs.

It could also be linked to changes in the genes.

If the patient has HIV virus infection, the patient may have a higher risk of getting multicentric Castleman disease.

Since the immune system is weak, the patient is more prone to have disorders from another virus called HHV-8.

Castleman disease has similar symptoms to lymphomas, cancers that involve the lymph nodes.

The diagnosis is made by histological examination of an excised lymph node.

If the patient has the unicentric type, the patient may require surgery to eliminate the swollen lymph node.

If the patient has MCD, the patient will require treatment that works throughout the body, since the disease has extended to many lymph nodes.

The treatment may be immunotherapy medicines such as:
1. Rituximab
2. Siltuximab
3. Tocilizu...

Dr. Kenneth Kee is a well-known medical doctor from Singapore who has been practicing medicine since 1972.
He graduated from the University of Singapore and furthered his studies with a Master of Science in Health Management in 1991, followed by a Ph.D. in Healthcare Administration in 1993.
Dr. Kee established Kee Clinic in 1974, located in the Holland Drive area of Singapore. The clinic has been a prominent feature of the community, offering general medical services for 5 decades.
Dr Kee also served his country Singapore as a national service police Inspector at night from 1975 to 1985 while working at his clinic during the day.
He had served as a police guard to the Woodland Petroleum Tanks at night during the Indonesian Confrontation period, took part in police rounds at night in the Beach Road area and taught First aid and emergency resuscitation to Police recruits.
He received the Singapore Police Bicentennial 2020 Medallion on 1st March 2024 as recognition for his work in the Singapore Police.
Even as he grew older, Dr. Kee continued to work actively in his clinic, although he eventually reduced his consultation hours.
Beyond his medical career, Dr. Kee is also an author.
He started writing about medical conditions in 2007, using blogs and other online platforms to share his knowledge with a broader audience.
Over time, he published various books, many of which provide simple and accessible guides to different health conditions.
His works include "A Family Doctor's Tale," "My Personal Singapore History," and numerous medical guides, available through platforms like Amazon.
His books often combine his personal experiences as a family doctor with insights into Singapore's healthcare system and history.
Dr. Kee has written extensively on health topics, contributing to both medical literature and general knowledge resources.

Dr. Kenneth Kee has written numerous books, primarily focused on health education and personal experiences as a family doctor. Some of his notable titles include:
"A Family Doctor's Tale"
This book is a blend of Dr. Kee's personal experiences and his reflections on being a family doctor in Singapore. It's a great choice if you're looking for a narrative that combines both medical knowledge and human stories.
"Specialized Medical Conditions"
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