Radiation therapy in the treatment of unicentric Castleman's disease

lymphocytes. There was concentric proliferation of endothelial cells in the central portion of the lesion, and the vascular lumen contained erythrocytes. These findings confirmed the diagnosis of CD. Because CD is a lymphoproliferative disease of indeterminate behavior, a decision was made to treat the patient as an outpatient, follow-up evaluations being performed every 6 months at our thoracic surgery, oncology, and hematology outpatient clinic and chest CT scans being taken during the follow-up period. A CT scan of the chest showed a slight increase in lesion size (72 × 55 mm), the lesion having no clear cleavage plane with the left descending pulmonary artery and being therefore deemed unresectable. Therefore, in August of 2009, the patient was referred to the radiation therapy department for evaluation. Between October 5, 2009 and November 16, 2009, the patient underwent three-dimensional radiation therapy at a total dose of 40 Gy, delivered in 20 fractions by a 6-MV linear accelerator. In addition to the tumor mass, the affected pulmonary hilar, subcarinal, and paratracheal lymph nodes were included in the radiation therapy fields. After the radiation therapy, the patient reported for follow-up evaluation every 3-4 months, a chest To the Editor: