ABSTRACT

To emphasize the hardship of diagnosing Castleman disease and present a potential treatment method.

A sixty-three-year-old male patient was admitted to the outpatient clinic with an attack of acute cholecystitis. The patient’s abdominal computed tomography revealed an incidentally detected lipid dense solid mass (64x53x37 mm) at the level of right renal hilum with 29x13 mm solid components in the middle. The patient was admitted to the urology department and underwent surgery where the mass was totally excised due to suspicion of a malignancy (liposarcoma). Histopathological examination later on resulted with unicentric Castleman disease, hyaline vascular subtype.

Since unicentric Castleman disease has an asymptomatic clinical course and is quite rare, it is necessary to rule out many potential possibilities before reaching a proper diagnosis. However, unicentric Castleman disease usually exhibits a good prognosis after the removal of the affected lymph node. Still, Castleman disease should be a candidate considered in the differential diagnosis of patients with incidentally discovered lymphadenopathy. On the whole, for a better understanding of underlying pathophysiology, there still lies a gap to be filled with knowledge acquired through further studies.

Keywords: Castleman disease, lymphoproliferative disorder, lymphadenopathy