Retroperitoneal paraduodenal unicentric Castleman disease: case report and review of the literature

Abstract

Castleman disease is a rare and benign disorder, characterized by enlarged lymph nodes and angiofollicular lymphoid hyperplasia. We report a case of a 57-year-old male, who was admitted to our surgical department because of a retroperitoneal nodular mass measuring about 4 cm in maximum diameter, incidentally discovered on a radiologic exam performed for the onset of vague abdominal pain with posterior irradiation. The patient was subdue to laparoscopic removal of the mass and no intra- and post-operative complications were recorded. Histologic diagnosis of hyaline-vascular variant of the Castleman disease was confirmed. Only two cases have been found in the literature reporting the paraduodenal unicentric Castleman disease localization like our case. Although rare, the Castleman disease must be considered in the differential diagnosis among all the lymph nodes diseases, for avoiding improper therapies.

Keywords: laparoscopic excision; lymphadenopathy; unicentric Castleman disease.

Figure 1

Transversal abdominal CT scan revealing a retroperitoneal polylobate neoformation in the right perirenal space.

Figure 2

Coronal abdominal CT scan revealing a retroperitoneal polylobate neoformation near the duodenum.

Figure 3

Hyperplasia of follicular dendritic cells (staining of follicular dendritic cells with anti-CD21 antibody).

Figure 4

Dysplasia of follicular dendritic cells.

Figure 5

Minimum amount of IgG4-secreting plasma cells (staining with anti-IgG4 antibody) (arrows).