Erkan Nazif, Yildirim Mehmet, Selek Elif, Sayhan Sehnaz
Department of 2nd Surgery, SSK Izmir Training Hospital, Izmir, Turkey.
JOP. 2004 Nov 10;5(6):491-4.
Castleman disease or giant lymph node hyperplasia is a rare disorder of the lymphoid tissue, usually occurring in the mediastinum. We report a case of localized peripancreatic plasma cell type Castleman disease, which is an unusual site.
A 45-year-old woman with a history of mild epigastric pain radiating to the back for the previous year was admitted and her physical examination was normal. A raised erythrocyte sedimentation rate, C-reactive protein and hypergammaglobulinemia were found. Abdominal ultrasonography and magnetic resonance imaging demonstrated a homogeneously hypoechoic solid mass having a smooth-surface, 6 cm in diameter, located between the head of the pancreas, the lower margin of the antrum and the left lobe of the liver. The mass was totally excised surgically with repair of the pancreas capsule. Histopathological examination of the tumor showed plasma-cell type Castleman disease.
Clinicians should be aware that Castleman disease may involve peripancreatic tissue which leads to difficulties in arriving at a differential diagnosis. Surgical excision is both a diagnostic and a curative method for management of the disease.
Castleman病或巨大淋巴结增生是一种罕见的淋巴组织疾病，通常发生于纵隔。我们报告一例局限性胰腺周围浆细胞型Castleman病，这是一个不常见的发病部位。
一名45岁女性，有上一年度轻度上腹部疼痛并向后背部放射的病史，入院时体格检查正常。发现红细胞沉降率、C反应蛋白升高及高球蛋白血症。腹部超声和磁共振成像显示一个直径6厘米、表面光滑的均匀低回声实性肿块，位于胰头、胃窦下缘和肝左叶之间。该肿块通过手术完全切除，并修复胰腺包膜。肿瘤的组织病理学检查显示为浆细胞型Castleman病。
临床医生应意识到Castleman病可能累及胰腺周围组织，这会给鉴别诊断带来困难。手术切除是该疾病诊断和治疗的方法。
