Unicentric Castleman's Disease Radiologically Mimicking Retroperitoneal Neoplasm, A Report Of Two Cases And Review Of The Literature (original) (raw)
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UNICENTRIC CASTLEMAN DISEASE PRESENTING AS A LARGE RETROPERITONEAL MASS-A CASE REPORT
Castleman disease (CD) described by castleman as a large,benign,asymptomatic mass involving mediastinal lymph nodes.The causes of CD are mostly unknown.As patients with CD can have markedly different presentation and clinical courses,with some lesions requiring innovative approaches to therapy, the major unifying feature is the histologic appearance. It may be unicentric or multicentric, hyaline-vascular variant or plasma cell variant. Unicentric variant mostly present as a isolated lymph node mass ,often mediastinal or cervical. We present a case of unicentriccastleman disease (hyaline vascular variant) presenting as a large retroperitoneal mass.
Retroperitoneal unicentric Castleman's disease with multiple lymph node involvement
BMJ case reports, 2011
A 78-year-old woman with B-symptoms was referred for a left adrenal incidentaloma of 5 cm. Imaging revealed features compatible with adrenal cancer. The authors excluded excess production of catecholamines or adrenal steroids. The tumour was removed by en bloc radical left retroperitonectomy with adrenalectomy, nephrectomy, interaortocaval lymphadenectomy and splenectomy. Histology demonstrated periadrenal hyaline vascular Castleman's disease with local infiltration and 14 positive lymph nodes. The lymphoid infiltrate spilled into the adjacent renal cortex. HHV8 was negative. The Ki67 proliferative index was 30-40% in germinal centres. There was no syn- or metachronous disease on extended imaging including fluorodeoxyglucose positron emission tomography-CT and narrow follow-up at 3 years. This is a rare case of unicentric hyaline vascular Castleman's disease with documented locoregional lymph node involvement. The case exemplifies the transition from unifocal unicentric dise...
A Case of Retroperitoneal Castleman's Disease and an Update on the Latest Evidence
Case reports in surgery, 2014
Castleman's disease is a benign lymphoproliferative condition with three distinct histological subtypes. Clinically it presents in either a unicentric or multicentric manner and can affect various anatomic regions, the mediastinum being the most frequent location. We herein present a rare case of unifocal retroperitoneal mass proved to be hyaline vascular Castleman's disease. We perform a review of the current literature pertaining to such lesions, focusing on the management of the various clinical and histological variants of the disease. Surgical excision is the treatment of choice for unifocal Castleman's disease.
A rare case of retroperitoneal castleman disease
IP innovative publication pvt. ltd, 2019
Castleman disease is a rare hyperplastic disorder that can affect any group of lymph nodes. Clinically and radiologically, it can mimic a malignancy and can only be diagnosed by histopathological examination. Castleman disease should be considered as one of the differential diagnosis for a patient presenting with a retroperitoneal mass. Complete surgical excision is usually curative; a preoperative diagnosis by biopsy can avoid extensive surgery for this condition. In this case report, we present a 40 year old female with a retroperitoneal mass, which was clinically suspected to be a malignancy. Complete surgical excision was done and histopathological examination of the mass revealed a unicentric Hyaline vascular type of Castleman disease.
A Case Report on Isolated Retroperitoneal Castleman's Disease
Castleman disease (CD) is an uncommon lymph proliferative disorder and is especially rare in the retro peritoneum or per renal area. Castleman disease is commonly misdiagnosed as malignant lymphoma, lymphadenitis or ectopic thymoma. So far, its diagnosis is mainly achieved via histopathological examination of surgically obtained tissue. After removal of the lesion, local CD has a good prognosis. It is a relatively rare disorder characterized by the benign proliferation of lymphoid tissue related to the chronic human herpes virus 8
World Journal of Surgical Oncology, 2014
Background Castleman’s disease is a rare and poorly understood disease entity that may resemble more common conditions and represents a clinical challenge to the treating surgeon. Case presentation In this report, we describe a case of a 61-year-old Caucasian woman with a symptomatic retroperitoneal mass. The specimen obtained from her resection contained a protuberant encapsulated mass, exhibiting microscopic features consistent with localized, unicentric Castleman’s disease. These characteristics included architectural features and immunohistochemical findings consistent with the hyaline vascular variant of Castleman’s disease. Conclusion We report a very rare case of a retroperitoneal hyaline vascular type of Castleman’s disease. We discuss the diagnostic dilemma Castleman’s disease may present to the surgeon, with an emphasis on multidisciplinary management of these patients. We also review current data on pathogenesis, treatment and outcomes.
Retroperitoneal unicentric Castleman's disease: A case report
INTRODUCTION: Castleman's disease (CD) is an angio-follicular lymph node hyperplasia presenting as a localized or a systemic disease masquerading malignancy. The most common sites of CD are mediastinum, neck, axilla and pelvis. Unicentric CD in the peripancreatic region is very rare. PRESENTATION OF CASE: We report a case of the 34-year-old lady presenting with epigastric pain for 3 months. Abdominal imaging revealed a retroperitoneal mass arising from the pancreas suspected to be neuroendocrine tumor. Tumor markers were not elevated. Complete surgical excision was performed and patient had uneventful recovery. Pathologic findings demonstrated localized hyaline-vascular type of Castleman's disease. DISCUSSION: CD is a very rare cause for development of retroperitoneal mass. It is more frequent in young adults without predilection of sex. It can occur anywhere along the lymphoid chain. Abdominal and retroperitoneal locations usually present with symptoms due to the mass effect on adjacent organs. CD appears as a homogeneously hypoechoic mass on ultrasound and non-specific enhancing homogeneous mass with micro calcifications on computed tomography. Histologically, the hyaline vascular type demonstrates a follicular and inter-follicular capillary proliferation with peri-vascular hyalinization, with expansion of the mantle zones by a mixed inflammatory infiltrate of numerous small lymphocytes and plasma cells. The standard therapy of localized form is en bloc surgical excision as performed in our case. CONCLUSION: Unicentric CD in the peripancreatic region is difficult to differentiate from pancreatic neoplasm preoperatively. However, preoperative biopsy in cases of high clinical suspicion can help in avoiding extensive surgery for this benign disease.
Unicentric retroperitoneal Castleman disease: Report of 3 cases
Cumhuriyet Medical Journal, 2015
Castleman Disease is a rare lymphoproliferative disorder mainly occuring in the mediastinum. Abdominal forms are less frequent and manifests rarely as an isolated retroperitoneal mass. The diagnosis is based on postoperative pathological findings. Herein, we report three cases of unicentric retroperitoneal Castleman Disease from our center. Three women were detected to have a retroperitoneal mass in the medical examinations. The masses were surgically removed and histopathological examination revealed a hyaline-vascular type of Castleman disease. Although retroperitoneal Castleman Disease is rare, it should be considered in the differential diagnosis of retroperitoneal masses.
Radiation Oncology, 2010
Background: Castleman disease (CD) is a rare benign disorder characterised by hyperplasia of lymphoid tissue that may develop at a single site or throughout the body. The etiology of this disorder is unclear, although the histopathological presentation can be differentiated into a hyaline vascular variant, a plasma cell variant and a mixed variant. Clinically, it has been recorded that 3 manifestations of CD are characterized: a localized unicentric type, a generalized multicentric type and a mixed form. Surgery remains the main treatment for resectable unicentric CD, since removal of the large node is possible without further complications. No consensus has been reached concerning the most adequate treatment for irresectable unicentric CD.