Sawaya Zeina, Semaan Dana B, Nicolas Gregory, Dib Abbas, Tayar Claude
Department of Surgery, Clemenceau Medical Center, Beirut, Lebanon.
Department of General Surgery, Clemenceau Medical Center, Beirut, Lebanon.
Am J Case Rep. 2020 Apr 4;21:e918444. doi: 10.12659/AJCR.918444.
BACKGROUND Castleman's disease is a benign, lymphoproliferative disorder that is extremely uncommon. Multiple classifications have been described; however, the exact etiology remains unknown. Preoperative diagnosis is not common, as imaging cannot distinguish the disease from other processes, and biopsy is insufficient to provide the architecture of the mass, which is necessary for diagnosis. Unicentric retroperitoneal disease has been described, and management includes complete resection of the mass, which is usually curative. CASE REPORT A 34-year-old previously healthy woman presented with hematuria. Evaluation revelated a retroperitoneal mass that was abutting the duodenum and head of the pancreas. Biopsy failed to provide a diagnosis, so laparoscopic resection was performed. Postoperative diagnosis was consistent with unicentric Castleman's disease. CONCLUSIONS Castleman's disease is an uncommon process, and one that is difficult to diagnose. Unicentric Castleman's disease should always be a differential diagnosis of solitary retroperitoneal masses that are well-demarcated, as treatment can be curative with surgical resection.
Castleman病是一种良性淋巴增殖性疾病，极为罕见。已有多种分类描述；然而，确切病因仍不清楚。术前诊断并不常见，因为影像学检查无法将该疾病与其他病变区分开来，且活检不足以提供肿块的结构，而这对于诊断是必要的。单中心腹膜后疾病已有报道，其治疗包括完整切除肿块，这通常可治愈。病例报告：一名34岁既往健康的女性出现血尿。检查发现一个腹膜后肿块，紧邻十二指肠和胰头。活检未能明确诊断，因此进行了腹腔镜切除。术后诊断为单中心Castleman病。结论：Castleman病是一种罕见的疾病，且难以诊断。单中心Castleman病应始终作为边界清晰的孤立性腹膜后肿块的鉴别诊断之一，因为手术切除治疗可能治愈。
