Radiation therapy in the management of giant lymph node hyperplasia

Abstract
The response of giant lymph node hyperplasia (Castleman's disease) to surgery is well known and surgery is the main technique in the management of these patients. We describe a young man who presented with clinical features suggestive of a lymphoma, but who was diagnosed to have Castleman's disease after histopathology. Complete response to radiation and a disease-free follow- up of 22 months prompts us to advocate radiation as an effective alternative mode of therapy in inoperable cases. Giant lymph node hyperplasia or Castleman's disease is a benign condition with enlargement of the lymph nodes, particularly common in the mediastinum. The patients are otherwise usually asymptomatic but may sometimes present with fever, anaemia, hyper-gammaglobulinaemia (Bartoli et al, 1980; Frrizera et al, 1983) and multi-centric lymph node enlargement (Gaba et al, 1978) mimicking a lymphoma.