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Indian Journal of Pathology: Research and Practice

Volume  9, Issue 2 (Part-1), May-August 2020, Pages 121-124
 

Case Report

Castleman Disease: Unusual Presentation of Solitary Neck Mass

Lena Abdul Baset Labania1, Maryam Nasir Hussain2, Sunil Kumar Bylappa3

1,2Postgraduate Intern, 3Anatomic Pathology Specialist and Lecturer, Thumbay Labs, Gulf Medical University, Ajman, United Arab Emirates.

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DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.9220.21

Abstract

Introduction: Castleman disease (CD) is a rare lymphoproliferative disorder characterized by enlargement of lymph nodes. The aim of the study was to present an unusual presentation of the disease. Due to very limited number of cases the exact statistical data is not available. CD is classified into two clinical entities; unicentric presentation with the disease confined to a single lymph node and a multicentric presentation characterized by generalized lymphadenopathy and a more aggressive clinical course. It is also classified based on the Histological appearance of the lymph node mainly, hyaline vascular type and plasma cell type.
Case Report: A case report of a 30-year old male presenting with swelling in the right side of the neck, gradually increasing in size, associated with on and off mild pain for more than a year. Physical examination, coagulation tests, infectious disease screening (HIV, HCV and HBsAg), ESR test and chest X-ray were all normal. Both computed
tomography (CT) and Ultrasonography (USG) findings showed a well-defined solid enhancing mass lesion in the inferior part of the right posterior triangle, extending in the supraclavicular fossa, with a displacement of the right jugular vein. Reactive lymphadenopathy features were seen in FNAC. Microscopic examination of Biopsy showed a well-encapsulated lymphnode tissue with an expanded mantle zone (paler areas), regressed follicles with radially penetrating sclerotic blood vessels (lollipop-like appearance), indicating a Unicentric Castleman disease, hyalinevascular type. Conclusion:Unicentric Castleman disease is a rare benign condition, surgical resection is curative. Histopathological examination rules out lymphoma and concluded that it is Unicentric Castleman disease, hyaline-vascular type case.

Keywords: Castleman Disease; Lymphadenopathy; Hyaline-vascular; Cervical; Lymph node; HIV.
 


Corresponding Author : Maryam Nasir Hussain