Mesenteric Castleman’s Disease with Systemic Symptoms in Children.

Castleman’s disease (CD) is a lymphoproliferative disorder of unknown origin and rarely occurs in children. It has been further classified into two major subgroups: solitary or localized and multicentric CD. Clinically, hyaline-vascular type is rarely associated with systemic symptoms, but the plasma cell type is frequently associated with the constitutional symptoms of fever, malaise, night sweat and the abnormal laboratory markers. We encountered a case of the hyaline-vascular type CD located in the mesentery with systemic symptoms. She admitted suffering from prolonged fever, anemia, poor weight gain, dyspnea, and abdominal distension. Labaroatory data showed that microcytic hypochromic anemia, polyclonal gammaglobulinemia, hyperfibrinogenemia, elevated C-reactive protein, and increased IL-6 level. Computed tomography confirmed that the mass was located in the mesentery with multiple lymphadenopathies. The clinical and biochemical abnormal findings improved after surgical resection of the involved lymph node. Currently she has no signs of recurrence at 12 months postoperatively.