Abstract
Castleman disease is a lymphoproliferative disorder with unknown etiology and pathogenesis. While the disease may involve all parts of the body, the mediastinum appears to be the most common part of involvement. In this study, we present two cases of Castleman disease with different localizations that mimicked malignancy. A 62-year-old female patient presented with jaundice. Laboratory analysis indicated aspartate aminotransferase: 250 U/L, total bilirubin: 4 mg/dl, and carbohydrate antigen (CA) 19-9: 900 U/ml. Computerized tomography (CT) of the abdomen showed a mass originating from the pancreas head which resulted in a biliary tract obstruction. A positron emission tomography-computed tomography (PET/CT) showed that the only site of involvement was the pancreas head. A decision was made to perform pancreaticoduodenectomy. During intra-abdominal exploration, lymphadenopathies were identified in the surroundings of the retropancreatic portal vein and the hepatic artery. Histopathological investigation of the dissected lymph nodes demonstrated findings consistent with granulomatous plasma-cell-rich Castleman disease. A 55-year-old female patient presented with abdominal pain, nausea, and vomiting. Computerized tomography of the abdomen showed an abdominal mass of 7 cm, originating from the mesenterium, with high-contrast uptake in the mesenterium in the lower abdominal quadrant. The mesenteric mass was resected along with segmentary small intestine resection. Histopathological investigation of the mass showed a giant granulomatous structure that consisted of plasma cells consistent with Castleman disease. Castleman disease should be kept in mind during differential diagnosis of locally advanced lymph nodes observed during preoperative investigations and intraoperative exploration.
Highlights
Castleman disease is a lymphoproliferative disease that was first described in 1956 by Castleman [1]
Histopathological investigation of the mass revealed a giant granulomatous structure that consisted of plasma cells
Epstein-Barr virus, Toxoplasma, and Mycobacterium tuberculosis are among the infectious agents that are held responsible for disease development
Summary
Castleman disease is a lymphoproliferative disease that was first described in 1956 by Castleman [1]. The patient’s medical and family history did not include any specific characteristics Her laboratory results were as follows; aspartate aminotransferase (AST): 250 U/L, total bilirubin: 4 mg/dl, and carbohydrate antigen (CA) 19-9: 900 U/ml. Histopathological investigation of the piece demonstrated findings consistent with Castleman disease rich in granulomatous plasma cells (Figure 2). A 55-year-old female patient presented with abdominal pain, nausea, and vomiting. The patient’s medical and family history did not include any specific characteristic Her blood pressure was 140/80 mmHg, and pulse was 85 (min) at presentation. Histopathological investigation of the mass revealed a giant granulomatous structure that consisted of plasma cells. In light of this information, the patient was screened for potential granulomatous diseases, such as tuberculosis and sarcoidosis. The patient is currently in the postoperative twelfth month, and she had been followed-up without any complications
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