UCD treatment algorithm. UCD patients should be evaluated for lymph node resectability, with surgery being the preferred method of treatment. ¹Consider presurgical embolization in large vascular UCD lymph nodes to render surgery safer. Follow-up CT scans, physical examination, and laboratory testing can be done at 12-month intervals. In rare patients who continue to have symptoms after complete lymph node excision, other diagnoses and/or treatments should be considered. ²Watchful observation is an option in patients with unresectable asymptomatic disease or those with nonsevere compressive symptoms. UCD patients with compression-related symptoms may benefit from medical treatment (eg, rituximab ± steroids or anti–IL-6 monoclonal antibody therapy) if inflammatory symptoms (night sweats, fevers, anorexia, weight loss) and/or laboratory abnormalities (elevated ESR, elevated CRP, or anemia) are present. ³In selected cases, embolization as alternative or adjunctive therapy should be considered. ⁴Observation is an option in patients who have been rendered asymptomatic by medical therapy with rituximab/steroids or anti–IL-6 monoclonal antibody therapy. ⁵Patients who continue to be symptomatic are candidates for radiotherapy. Alternative options include treatment with immunomodulators/immunosuppressants, such as corticosteroids, cyclosporine A, and sirolimus.