Department of Stomatology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, 210012, Jiangsu, China.
J Med Case Rep. 2024 Apr 3;18(1):140. doi: 10.1186/s13256-024-04468-5.
Castleman's disease is a rare lymphoproliferative disorder that is often misdiagnosed because of its untypical clinical or imaging features except for a painless mass. Besides, it is also difficult to cure Castleman's disease due to its unclear pathogenesis.
We present a Castleman's disease case with diagnostic significance regarding a 54-year-old Chinese male who has a painless mass in his left parotid gland for 18 months with a 30-years history of autoimmune disease psoriasis. Computed tomography scan showed a high-density nodule with clear boundaries in the left parotid and multiple enlarged lymph nodes in the left submandibular and neck region. General checkup, the extremely elevated serum interleukin-6 and lymph node biopsy in the left submandibular region gave us an initial suspicion of Castleman's disease. Then the patient underwent a left superficial parotidectomy. Based on histopathologic analysis, we made a certain diagnosis of Castleman's disease and gave corresponding treatments. In 18 months of follow-up, the patient showed no evidence of recurrence, with the level of serum interleukin-6 decreased.
Clinicians should be aware of the possibility of Castleman's disease when faced with masses or enlarged lymph nodes in the parotid gland to avoid misdiagnosis, especially in patients with autoimmune diseases and elevated serum interleukin-6.
卡斯特曼病是一种罕见的淋巴组织增生性疾病，由于其非典型的临床或影像学特征，除了无痛性肿块外，常常被误诊。此外，由于其发病机制尚不清楚，卡斯特曼病也难以治愈。
我们报告了一例具有诊断意义的卡斯特曼病病例，患者为 54 岁中国男性，18 个月前左腮腺无痛性肿块，有 30 年自身免疫性疾病银屑病病史。计算机断层扫描显示左腮腺边界清楚的高密度结节和左颌下及颈部多个增大的淋巴结。全身检查，血清白细胞介素-6 极度升高，左颌下淋巴结活检初步怀疑卡斯特曼病。随后患者接受了左腮腺浅叶切除术。根据组织病理学分析，我们明确诊断为卡斯特曼病，并给予相应治疗。在 18 个月的随访中，患者无复发迹象，血清白细胞介素-6 水平降低。
当腮腺出现肿块或淋巴结肿大时，临床医生应意识到卡斯特曼病的可能性，以避免误诊，特别是在自身免疫性疾病和血清白细胞介素-6 升高的患者中。
