Splenectomy induced complete remission in a patient with multicentric Castleman's disease and autoimmune hemolytic anemia

Castleman's disease (CD) is a rare disorder of the lymphoid tissue in which the clinical manifestations often mimic a malignant lymphoma. Despite the absence of monoclonality of the lymphoid proliferation, the multicentric va riant of the disease (MCD) is characterized by severe symptoms and poor pro gnosis. Etiologic, pathogenetic, and therapeutic aspects of MCD are still u ncertain. We report the case of a 57-year-old patient affected by MCD compl icated by severe immunohemolytic anemia. Whereas the clinical and laborator y response to steroids and chemotherapeutic agents was only partial, splene ctomy induced a complete remission of hemolysis and disappearance of the co nstitutional symptoms and of all generalized lymphadenopathies.