Clinical Case of Castleman’s Disease Located at the Mesorectum

Introduction: A rare benign lymphoid proliferative disorder called Castleman’s disease is the most commonly presented as a solitary mass in the mediastinum, although sometimes with sites at the neck, axilla, mesentery, pancreas, pelvis and retroperitoneum. We report a case of Castleman’s disease in the mesorectum. According to the literature, such localization was visualized just in few cases all over the world. Case History: The patient was a 48-year-old man, who complained of lumbar pain. MRI was performed in 2014 on which the formation in the presacral mass of mesorectal fat (size up to 4,9*5,2*4,0 cm) on the level of S2 vertebrae was found, which is considered as a lymph node with the tendency to increase during 3, 5 years (+1cm). Upon admission to the clinic, differential diagnosis with lymphoma and malignant tumor were carried out. According to the colonoscopy, there were no evidence about any malignancies in the bowel. After laparoscopic removing of the mesorectal tumor and histological examination of the specimen immunohistochemistry assay was recommended. Following the analysis, the hyaline-vascular type of Castleman's disease was confirmed. Chemotherapy wasn’t recommended, because of radical surgical treatment. According to the results of monitoring in two years, no data of recurrence were identified. Conclusion: Castleman’s disease should be taken into consideration in the differential diagnosis of lymphoid formations in mesorectum.

Castleman’s disease: an entity forgotten in ENT

<p class="abstract">Castleman’s disease (CD) usually presents as localized or systemic lymphadenopathy or as an extra nodal mass. The usual site of presentation are mediastinum, retroperitoneum, axilla and mesentery. Only 3 cases of CD have been reported in retro pharyngeal space. We report a case of 20 year old male patient with retropharyngeal mass. He presented with difficulty in swallowing, change in voice and respiratory distress. The mass was removed in-toto transorally after performing elective tracheostomy. The histopathological findings were consistent with hyaline vascular type of CD. He was decannulated after two day and postoperative period was uneventful. Postoperative CT imaging confirmed the complete excision of tumor and patient is on follow up, with no signs of recurrence. The presentation of tumour in the retropharyngeal space which is a rare site of occurrence add to the uniqueness of this case. Unicentric CD has an excellent prognosis and surgery is the management of choice. Its clinical features, histological subtypes, treatment modalities and prognosis are discussed.</p>

Idiopathic Multicentric Hyaline Vascular-Type Castleman Disease

Castleman disease is a rare lymphoproliferative disorder presenting with localized or disseminated lymphadenopathy and systemic symptoms. It can be categorized clinically as unicentric or multicentric, histopathologically as hyaline vascular, plasma cell, or mixed variant, and etiologically, considering the subtypes based on causative viral agents and associated syndromes. The multicentric type can mimic other haematological malignancies, ranging from asymptomatic to multiple organ involvement. Although its pathophysiology is not well known, the current approved treatments are directed towards interleukin-6, CD-20, and viral agents. The authors present an 82-year-old leucodermic man presented with a 2-week history of constitutional symptoms. Examination revealed pallor, hepatosplenomegaly, and palpable left axillary lymphadenopathy. Investigation showed anaemia, thrombocytopenia, polyclonal hypergammaglobulinemia, hypoalbuminemia, and high acute phase reactants, with image study revealing multiple axillary, mediastinal, inguinal, and pelvic lymphadenopathies. The lymph node biopsy was consistent with hyaline vascular-type Castleman disease without human herpersvirus-8 markers. He started prednisolone with initial improvement evolved poorly on a short term. Castleman disease has a broad spectrum of clinical manifestations, associations, and complications that bring a diagnostic challenge, requiring a multidisciplinary approach. Clinicians should be familiar with its features because proper diagnosis and aggressive targeted treatment are the pillars of proper management of these patients.

Different Imaging Features of Retroperitoneal Unicentric Castleman’s Disease: A Case Report

Castleman’s disease is a rare disease which is difficult to diagnose early due to its lack of specific manifestations, and also is easily confused with lymphoma or other solid tumors. Castleman’s disease can occur in any part of the body containing lymph nodes and is most common in the chest, followed by the neck, abdomen, and axillae. A 37-year-old woman was admitted to our hospital because of a tumor near the adrenal gland found by computed tomography. Positron emission tomography-computed tomography revealed that the retroperitoneal tumor may be a malignant disease. However, the pathological diagnosis after laparoscopic resection was retroperitoneal Castleman’s disease, hyaline vascular type.

Retroperitoneal Castleman’s Disease

Castleman’s disease was first reported in 1954 by Castleman et al. and identified as an uncommon lymphoproliferative disorder. In most cases, Castleman’s diseases are detected in the chest, head, and neck. A 71-year-old man was referred to our hospital due to a retroperitoneal tumor in the para-aortic area by computed tomography (CT). Positron emission tomography-CT revealed an uptake in this tumor, suggesting malignant diseases. Laparoscopic tumorectomy was performed, and the pathological diagnosis was Castleman’s disease, hyaline vascular type. No evidence of recurrence was observed 20 months after surgery. We herein report a rare case of retroperitoneal Castleman’s disease.

Unicentric Castlemans disease presenting as a neck swelling: a case report

Castleman’s disease is an uncommon entity which is characterized by lymphadenopathy either at a single focus or at multiple sites.Due to the similar clinical picture of other disorders including tuberculous lymphadenitis, lymphoma and other cases of generalized lymphadenopathy like AIDS a diagnosis of castlemans disease. The unicentric form may resemble any generalized swelling such as a lipoma. In this case we discussed an 18 yr old girl presenting with a large neck swelling in the posterior triangle which clinically resembled a lipoma. The CT showed a uniformly enhancing homogenous lesion. After an excision biopsy, the histopathology revealed it to be castleman’s disease of the hyaline vascular type. The literature reveals that although rare castlemans disease can be unicentric or multicentric and can involve multiple sites including the axilla, mediastinum and retroperitoneum. Most cases of the unicentric disease are completely cured with an excision biopsy. The multicentric disease may need chemotherapy, radiation or immunomodulating drugs. In conclusion, one must keep a differential of castlemans disease in mind when presented with any case of lymphadenopathy.

Unicentric Castleman’s Disease in a Man Originally Diagnosed with Sarcoidosis: A Case and Analysis of the Key Differences in Diagnosis

Castleman Disease (CD) is a lymphoproliferative disorder characterized by enlarged hyperplastic lymph nodes with regressed follicles surrounded by expanded mantle zones of small lymphocytes, and interfollicular vascular proliferation in the hyaline-vascular type. There are two types: unicentric and multicentric. Unicentric, hyalinevascular type of Castleman’s disease can be treated successfully with complete surgical resection with monitoring for reoccurrence. Here we report a case of a patient originally diagnosed with sarcoidosis who was found to have Unicentric Castleman’s disease.

Unicentric Castleman’s disease located between the aorta and inferior vena cava: A case report

We report a 70-year-old woman diagnosed with unicentric Castleman’s disease with a contrast well-enhanced retroperitoneal tumor of 25 mm in diameter that located between the aorta and inferior vena cava. The imaging finding did not suggest any specific features, and no other lesion was detected. Laboratory examinations indicating malignant lymphoma such as soluble interleukin-2 were all negative. We resected the retroperitoneal tumor laparoscopically, and histopathological examination revealed hyaline vascular type Castleman’s disease. Although complete resection of hyaline vascular type unicentric Castleman’s disease results in a good prognosis, a late relapse has been reported and long-term follow-up is warranted.