- Low-grade fever.
- Weight loss.
- Skin rash.
- Excessive sweating.
- Night sweats.
- Loss of appetite.
- Nausea and vomiting
- Enlarged peripheral lymph nodes, usually around the neck, collarbone, underarm and groin areas.
- Enlarged liver or spleen
- Nerve damage in the hands and feet that leads to numbness or weakness (peripheral neuropathy).
- Blood and urine tests: Blood and urine tests may help your doctor rule out other infections or diseases. They can also reveal anemia and abnormalities in blood proteins that are sometimes characteristic of Castleman disease.
- Imaging techniques: An X-ray, computerized tomography (CT) scan or magnetic resonance imaging (MRI) scan of your chest, neck, abdomen and pelvis may detect the presence and number of enlarged lymph nodes. These tests can also determine whether organs, such as your liver or spleen, are enlarged. Positron emission tomography (PET) scans also may be used in diagnosing Castleman disease and later, to assess whether a treatment is working.
- Lymph node biopsy: To differentiate Castleman disease from other types of lymphatic tissue disorders, such as lymphoma, it's necessary to take a sample of lymph node tissue for examination in the laboratory. If the enlarged lymph node is close to the surface of your skin, the biopsy can be done under local anesthesia. If it's in your chest or abdomen, more extensive surgery may be necessary to access the lymph node. By looking at the structure of the cells, a doctor who specializes in diagnosing disease (pathologist) may be able to tell whether it's lymphoma or Castleman disease.
- Immunohistochemistry: In this test, a part of the biopsy sample is treated with special man-made antibodies. The cells are treated so that certain types of cells change color. The color change can be seen under a microscope. It may help tell whether there is CD or lymphoma in the lymph node.
- Flow cytometry: Cells from the lymph node are treated with special manmade antibodies and passed in front of a laser beam. Each antibody sticks only to certain types of cells. If the sample contains those cells, the laser light causes them to give off light of a different color. The intensity of each color is measured exactly and analyzed by a computer. This test can help determine whether lymph node swelling is caused by lymphoma, some other cancer, or a non-cancerous disease like Castleman disease.
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