Castleman's Disease: An Intrapulmonary Form with Intrafissural Development

Castleman's disease (CD) is an uncommon, mainly benign, lymphoproliferative disorder of unknown etiology, mostly involving the mediastinum. Parenchymal lung involvement of the disease is exceedingly rare. We describe a case of CD in a 23-year-old woman with a 4-year history of recurring dyspnea and nonproductive cough, whose chest X-ray showed an abnormal shadow of the right hilum. Chest computed tomography confirmed the presence of a tissue-density mass of the right lower lobe, demonstrating poor contrast enhancement, associated with multiple laterotracheal and mediastinal lymphadenopathies. The patient underwent curative surgery, revealing a right hilar compressive mass, with an intrafissural development between the superior and middle lobes. Pneumonectomy was performed due to profuse bleeding. This case of CD is particular because of its unusual intrapulmonary location and its intrafissural development. Poor contrast enhancement is atypical in CD.

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Pulmonary Tuberculosis mimicking a right Eventration on Radiography: The falsity of single view radiograph in the diagnosis of a precursor of pulmonary disease: A Case Report

Babcock University Medical Journal (BUMJ) ◽

10.38029/bumj.v4i1.65 ◽

2021 ◽

Vol 4 (1) ◽

pp. 33-37

Author(s):

John Ogunkoya ◽

Oluwatosin Yetunde Adesuyi

Keyword(s):

Pulmonary Tuberculosis ◽

Lower Lobe ◽

Middle Lobe ◽

The Body ◽

Single View ◽

Lymph Node Enlargement ◽

History Of ◽

Chest X Ray ◽

The Right ◽

High Index Of Suspicion

Background: The diaphragm is one of the most important muscles of respiration in the body separating the abdomen from the thorax. Abnormalities of the diaphragm could be congenital or acquired, morphological or functional while pulmonary infection e.g. pulmonary tuberculosis, is implicated in its etiology. Case presentation: A 63-year- old man with six weeks history of cough productive of yellowish sputum. Chest X-ray showed a uniform well-circumscribed opacity in the right lower lobe abutting on or in continuum with the right diaphragm consistent with a diaphragmatic hump. Sputum Gene Xpert was positive for Mycobacterium tuberculosis. Chest CT scan revealed bilateral lymph node enlargement with hyperdense lesions in the anterior basal segment of the right lower lobe and medial bronchopulmonary segments of the right middle lobe. He was treated for 6 months with first-line anti-tuberculosis drugs. Discussion: The incidence of the diaphragmatic hump on chest radiograph worldwide and among Nigerians is unknown. The association of diaphragmatic hump with chest infection has been well document. The association of diaphragmatic hump with pulmonary tuberculosis is uncommon. Conclusion: A high index of suspicion is needed to diagnose pulmonary tuberculosis with atypical clinical and radiological presentations. Such prompt diagnosis will aid the treatment of the disease.

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Meningococcal Pneumonia in a Young Healthy Male

Case Reports in Infectious Diseases ◽

10.1155/2018/2179097 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Abdullah M. Al Alawi

Keyword(s):

Emergency Department ◽

Lower Lobe ◽

Community Acquired Pneumonia ◽

Cell Counts ◽

History Of ◽

Chest X Ray ◽

White Blood Cell Counts ◽

The Right ◽

Local Guideline

A 23-year-old male presented to the emergency department with one-day history of right-sided pleuritic chest pain, haemoptysis, and fever. In the emergency department, the blood pressure was 140/60 mmHg, heart rate 89/min, body temperature 40°C, respiratory rates 20 breaths/min, and oxygen saturation 98% in room air. Physical examination revealed rales and bronchial breathing in the right infrascapular region. Laboratory analysis showed raised white blood cell counts and elevated inflammation markers. Chest X-ray showed right lower lobe consolidation. Intravenous(IV) ceftriaxone and doxycycline were started for the management of community-acquired pneumonia as per the local guideline. Later, on admission, blood culture was positive for Neisseria meningitidis (N. meningitidis). Ceftriaxone was continued for 4 days, and the patient was discharged while being on oral amoxicillin (1 gm TDS) for another 3 days. He remained well during the outpatient follow-up.

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Localized Castleman’s Disease in the Breast in a Young Woman

Case Reports in Pathology ◽

10.1155/2016/8413987 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Rafael Parra-Medina ◽

José Ismael Guio ◽

Patricia López-Correa

Keyword(s):

Lymphoproliferative Disorder ◽

Histopathological Examination ◽

Castleman’S Disease ◽

Unknown Etiology ◽

Castleman's Disease ◽

Axillary Lymphadenopathy ◽

The Right ◽

Slow Growing ◽

Hyaline Vascular Variant

Castleman’s disease (CD) is a rare lymphoproliferative disorder of unknown etiology. It typically occurs in adulthood but it may also develop in childhood. Clinically, this disease may be classified as localized (unicentric) or systemic (multicentric). Six cases of breast CD have been described in the literature, and all have been reported in adults. Herein we describe the case of a 15-year-old female who presented with a slow-growing tumor in the right breast. The tumor was excised and histopathological examination demonstrated hyaline vascular variant CD. After two years of follow-up, the patient was asymptomatic without evidence of cervical or axillary lymphadenopathy.

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Burkholderia cepacia: An unusual cause of pneumonia

IP Indian Journal of Immunology and Respiratory Medicine ◽

10.18231/j.ijirm.2021.054 ◽

2021 ◽

Vol 6 (4) ◽

pp. 249-252

Author(s):

Arjun A S ◽

Prasanna Kumar T ◽

Manjunath H K

Keyword(s):

Burkholderia Cepacia ◽

Lower Lobe ◽

Lung Abscess ◽

High Grade Fever ◽

Home Setting ◽

Prescription Practices ◽

Male Farmer ◽

History Of ◽

Chest X Ray ◽

The Right

Burkholderia Cepacia is a gram negative organism, an uncommon cause of pneumonia. When isolated, it usually represents colonisation. In the presence of immunocompromising conditions, it can cause disease, ranging from mild illness to the highly fatal Cepacia syndrome. The organism is intrinsically resistant to many antibiotics. We report a 57 years old male farmer, who has diabetes mellitus and bronchial asthma, who presented with a acute history of high grade fever, pain abdomen and cough. He was diagnosed with a ruptured liver abscess, with the infection spreading to the right lower lobe. Laparotomy was performed. Pus culture grew Pseudomonas aeruginosa. He improved upon antibiotic therapy, only to return after one month with severe cough, chest X-ray revealing a lung abscess in the right lower lobe. Bronchoalveolar lavage culture grew Burkholderia cepacia, and sensitive antibiotics were initiated, however the patient succumbed to the illness. The implicated source of the organism was the nebulisation solution which he was using regularly. Emphasis should be laid on the need for improved aseptic practices while using medical solutions at either hospital or home setting. An index of suspicion may guide optimal antibiotic prescription practices in susceptible individuals.

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Castleman’s disease presenting as parotid mass: a case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190786 ◽

2019 ◽

Vol 5 (2) ◽

pp. 504

Author(s):

Ankur Batra ◽

Megha Goyal

Keyword(s):

Castleman’S Disease ◽

Surgical Excision ◽

Needle Aspiration ◽

The Body ◽

Unknown Etiology ◽

Castleman's Disease ◽

Nerve Preservation ◽

Parotid Region ◽

The Right ◽

Conclusive Diagnosis

Castleman’s disease is a rare, benign, lymphoproliferative disorder of unknown etiology. It can involve any lymph node group in the body with mediastinum being the commonest site. Salivary glands are affected rarely. We report a 35 year old male patient who presented with slowly progressive, painless right sided parotid swelling for 3 years. Clinical examination showed a 4×3 cm single, firm, non-tender, non-pulsatile swelling with smooth surface and normal overlying skin present in the right parotid region. Magnetic resonance imaging (MRI) revealed a well-defined hyper-intense mass lesion on T2 measuring 3.9×3×2.8 cm and Fine needle aspiration cytology (FNAC) showed intense lymphoplasmacytic infiltrates. No conclusive diagnosis could be made on the basis of FNAC. So, the excision of parotid mass with facial nerve preservation was done. The final histopathology confirmed the diagnosis as Castleman’s disease. Although Castleman’s disease in the parotid gland is rare, clinicians should consider it as the differential diagnosis of any solid tumors that exhibit non-specific presenting characteristics and surgical excision is preferred treatment for unicentric disease.

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A rare cause of wheezing

Chest Disease Reports ◽

10.4081/cdr.2016.5938 ◽

2016 ◽

Vol 4 (1) ◽

Author(s):

Alexander H. Cho ◽

Jessica Logan ◽

Jalil Ahari

Keyword(s):

Granular Cell ◽

African American Female ◽

Lobe Bronchus ◽

Submucosal Tumors ◽

Sputum Production ◽

Endobronchial Lesion ◽

History Of ◽

Chest X Ray ◽

The Right ◽

Tomography Scan

A 24-year-old African American female nonsmoker, with a reported history of asthma presented to the hospital with 2 weeks of shortness of breath and sputum production. She had a chest X-ray and computed tomography scan that displayed evidence of a right upper lobe collapse. She subsequently had a bronchoscopy that revealed an endobronchial lesion at the opening of the right upper lobe bronchus. Biopsies performed were consistent with a granular cell tumor. Granular cell tumors are rare submucosal tumors of Schwann cell origin. Resection of the right upper lobe resolved her symptoms and wheezing.

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Unicentric Castleman's Disease Arising from an Intrapulmonary Lymph Node

Case Reports in Surgery ◽

10.1155/2013/289089 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Hideki Ota ◽

Hideki Kawai ◽

Tsubasa Matsuo

Keyword(s):

Lymph Node ◽

Ct Angiography ◽

Preoperative Diagnosis ◽

Castleman’S Disease ◽

Unknown Etiology ◽

Imaging Features ◽

Castleman's Disease ◽

3D Ct ◽

Imaging Characteristics ◽

3D Ct Angiography

Castleman's disease is an uncommon lymphoproliferative disorder of unknown etiology, most often involving the mediastinum. It has 2 distinct clinical forms: unicentric and multicentric. Unicentric Castleman's disease arising from an intrapulmonary lymph node is rare, and establishing a preoperative diagnosis of this disease is very difficult mainly due to a lack of specific imaging features. We report a case of intrapulmonary unicentric Castleman's disease in an asymptomatic 19-year-old male patient who was accurately diagnosed by preoperative computed tomography (CT). The mass was incidentally found on a routine chest X-ray. A subsequent dynamic CT showed a well-defined, hypervascular, soft-tissue mass with small calcifications located in the perihilar area of the right lower lung. Three-dimensional CT (3D-CT) angiography indicated that the mass was receiving its blood supply through a vascular network at its surface that originated from 2 right bronchial arteries. The clinical history and CT findings were consistent with a diagnosis of unicentric Castleman's disease, and we safely and successfully removed the tumor via video-assisted thoracoscopic surgical lobectomy. This case shows that the imaging characteristics of these rare tumors on contrast-enhanced CT combined with 3D-CT angiography can be helpful in reliably establishing a correct preoperative diagnosis.

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A Case of Spondyloarthritis in Patient Affected by Unicentric Castleman’s Disease Effectively Managed with Surgery Resection and Tocilizumab Treatment

Case Reports in Rheumatology ◽

10.1155/2018/5067239 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

M. Filippini ◽

S. Cartella ◽

O. Bonzanini ◽

E. Morello ◽

A. Tincani

Keyword(s):

Marked Improvement ◽

Late Onset ◽

Castleman’S Disease ◽

Castleman's Disease ◽

Hla B27 ◽

History Of ◽

Inflammatory Drugs ◽

Rheumatologic Manifestations ◽

Surgery Resection

A 38-year-old woman was referred to our hospital for rheumatologic manifestations (migrant arthritis and tenosynovitis), without psoriasis or family history of psoriasis, gastroenteric manifestations, or recent genitourinary infections. The instrumental and laboratory tests have suggested a diagnosis of undifferentiated seronegative HLA-B27-positive spondyloarthritis with predominantly peripheral involvement. The symptoms were very severe and resistant to anti-inflammatory drugs and steroids. She had a history of hyaline-vascular unicentric Castleman’s disease (HBV, HIV, and HHV-8 negative) treated with surgery resection. After a first pharmacological attempt with sulfasalazine (suspended for urticarial rash), we managed the patient with monotherapy tocilizumab 8 mg/kg, with full response of rheumatologic manifestations. The efficacy of tocilizumab was confirmed even after a follow-up of three years. Our experience seems to describe a new late-onset autoimmune disease (only 21 cases described in literature) potentially related to Castleman’s disease. The patient experienced marked improvement from IL-6-based therapy (tocilizumab).

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A Fatal Case of COVID-19 in an Infant with Severe Acute Malnutrition Admitted to a Paediatric Ward in Niger

Case Reports in Pediatrics ◽

10.1155/2020/8847415 ◽

2020 ◽

Vol 2020 ◽

pp. 1-3

Author(s):

Alido Soumana ◽

Aboubacar Samaila ◽

Lamine Mahaman Moustapha ◽

Moumouni Kamaye ◽

Balkissa Daouda ◽

...

Keyword(s):

Nasal Swab ◽

Severe Acute Malnutrition ◽

Fatal Case ◽

Acute Malnutrition ◽

Rt Pcr ◽

X Ray ◽

Laboratory Confirmation ◽

History Of ◽

Chest X Ray ◽

The Right

While there have been very few fatal cases, SARS-CoV-2 has been reported in paediatric patients. This study aims to describe a fatal case of COVID-19 in a child with severe acute malnutrition. The eight-month-old child presented with fever, diarrhoea, and difficulty in breathing. The mother of the child had fever and shortness of breath four weeks before she died. Physical examination revealed lethargy, dehydration, and severe weight loss with a weight of 5 kg at a height of 78 cm tall. The weight-for-height index was less than three Z-scores, which corresponds to severe acute malnutrition. The pulmonary examination revealed moderate respiratory distress, and the chest X-ray presented features suggestive of pneumonia in the right lung area. In the context of the COVID-19 outbreak in Niger and the circumstances of the mother’s death, a nasal swab was taken for laboratory confirmation. Treatment provided to the child included intranasal oxygen, antibiotics, and a dietary program with therapeutic milk. The child died 48 hours after his admission. The history of contact with a SARS-CoV-2 suspect or positive patient should lead to screening for infection by using RT-PCR. It is important to investigate malnutrition as a potential risk factor for severe SARS-CoV-2 infection and resultant mortality.

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A Palpable Painless Axillary Mass as the Clinical Manifestation of Castleman’s Disease in a Patient with Hepatitis C Disease

Case Reports in Medicine ◽

10.1155/2016/1970276 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Athanasia K. Papazafiropoulou ◽

Angeliki M. Angelidi ◽

Antonis A. Kousoulis ◽

Georgios Christofilidis ◽

Chariklia Sagia ◽

...

Keyword(s):

Hepatitis C ◽

White Male ◽

Castleman’S Disease ◽

Young Patients ◽

Low Grade ◽

Castleman's Disease ◽

Complete Excision ◽

Axillary Mass ◽

Painless Mass ◽

The Right

Introduction. Castleman’s disease (CD) is a rare lymphoproliferative disorder. CD is divided into two clinical subtypes: the most common unicentric and the less usual multicentric subtype. The majority of unicentric CD affects the mediastinum, while neck, abdomen, and axilla are less common locations.Case Presentation. Herein, we describe a rare case of unicentric CD in the right axilla in a 36-year-old white male with a medical history of hepatitis C virus infection admitted to our hospital due to palpation of a painless mass in the right axilla. Complete excision of the lesion was performed and, one year after the diagnosis, patient was free of the disease.Conclusions. Although infrequent, it is important to include CD in the differential diagnosis when evaluating axillary lymphadenopathy particularly in young patients with a low-grade inflammation process and chronic disease even in the absence of an abnormal blood picture or organomegaly.

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