Giant lymph node hyperplasia is a rare disorder of lymphatic system which is also called as Castleman’s disease or angiofollicular lymph node hyperplasia. It can be localized or widespread, but it’s not a cancer. It is a lymphoproliferative disorder characterized by an abnormal or over growth of lymph system is observed. Many people with this condition eventually develop lymphomas (cancer of lymph nodes). Commonly it occurs in the chest, abdomen, neck, axilla, pelvis, and pancreas.
The signs and symptoms differ based on the type. The symptoms of localized type include:
The signs and symptoms of multicentric type include:
The causeof giant lymph node hyperplasia is not clear. Herpes virus 8 (HHV-8) is associated with multicentric giant lymph node hyperplasia. The HHV-8 develops Kaposi’s sarcoma (cancerous tumor of blood vessel walls). Interleukin-6 (IL-6) produced by the immune system, contributes to the overgrowth of lymphatic cells.
The diagnostic tests for giant lymph node hyperplasia include
Blood and Urine Tests :Infections and other type of diseases can be identified by these tests. These tests will be useful to identify abnormalities in blood proteins.The treatment depends on the type of condition.
Localized : The localized lumps can be removed surgically. If surgery is not possible, then other treatment techniques such as medications or radiation technique can be used to shrink or destroy the lymph node.The treatment of multicentric type usually involves medications and other therapies to control the over growth of the cells. The treatment depends on the extent of the condition and whether the patient has HIV or HHV-8 or both.
Monoclonal Antibodies : If the patient does not have HIV or HHV-8 infection, then the initial treatment can be with a monoclonal antibody such as siltuximab. Monoclonal antibodies are used to block the action of IL-6 protein which is involved in cell overgrowth.Giant lymph node hyperplasia is classified into two main types. They are:
Localized : It is the most common type and it affects only single group of lymph nodes. They are mostly observed in chest and abdomen. The enlarged lymph nodes in the chest cause breathing problems by pressing the trachea or small breathing tubes. The enlarged lymph nodes in the abdomen can cause pain, a feeling of fullness, or trouble eating. Sometimes they are formed in the neck, groin or under arm which are identified as lumps. The affected lymph nodes can be removed by surgery.Giant lymph node hyperplasia is also classified based on how the lymph nodes appear under the microscope. These are called microscopic subtypes.
Hyaline vascular Type : It is the most common type and it is localized. In very rare cases, it can be multicentric. It often have few symptoms.