Late recurrence of Castleman’s disease with mixed angiomyoid, histiocytic reticulum cell, follicular dendritic cell stroma-rich proliferations: a case report and review of the literature

Abstract

Castleman disease, hyaline vascular variant (HV-CD) involving lymph nodes is characterized by abnormal follicles with increased vascularity, hypervascular interfollicular tissue, absence of sinuses, and follicles having the characteristic “onion skin-like” appearance. We present a rare case of HV-CD, stroma-rich variant, which recurred less than 5 years after initial surgical therapy. The recurrent lesion varied in appearance from classical morphology of HV-CD with a stromal proliferation of follicular dendritic, angiomyoid cells, and histiocytic reticulum cells. Less than fifty cases of stroma-rich Castleman disease have been reported in the literature. To the best of our knowledge, this is the first case showing a mixed proliferation of stromal elements with rims of compressed normal lymphoid tissue and recurrence after surgical excision.