Primary hyaline vascular Castleman disease of the kidney: case report and literature review

Abstract

Background Castleman’s disease (CD) is an uncommon type of benign proliferation of the lymphoid tissue, characterized by local or systemic lymphadenopathy that most frequently appears in the mediastinum; involvement of the kidney is uncommon, and proliferation originating from the kidney is extremely rare. Herein, we report a rare case of hyaline vascular Castleman’s disease (HV-CD) in a 56-year-old male patient and discuss its morphological characteristics and differential diagnoses including mantle cell lymphoma (MCL), follicular lymphoma (FL), and nodal marginal zone lymphoma (NMZL). Case presentation A right upper-middle renal mass was detected after physical examination in a 56-year-old man without any clinical symptoms and a previous partial resection of the right kidney. Microscopically, the lymphoid follicles were increased in number and had expanded mantle zones and atrophic germinal centers. Vascular proliferation and hyalinization in the interfollicular zones were observed. Immunohistochemical staining showed CD20-positive cells in the mantle zones; CD21 and CD35 were expressed in the dendritic cells, CD3 was positive in a small number of T cells, and CD38 and CD138 were positive in the plasma cells. Additionally, Ki-67 expression was positive in the follicle centers. In contrast, staining for Bcl-2 in the germinal centers and cyclin D1 were negative. The immunohistochemical analysis combined with the morphological results supported the diagnosis of HV-CD. The patient recovered well after surgery. Conclusions Primarily renal HV-CD without lymph node hyperplasia or clinical symptoms is extraordinarily rare and different from the multicentric-type CD (MCD) with kidney involvement. Therefore, it is extremely important to improve the awareness of this diagnosis. Attention should be paid to the difference between HV-CD and common lymph node reactive hyperplasia, MCL, FL, NMZL, and so on. To avoid misdiagnosis as a renal malignant tumor requiring radical resection, distinguishing these diseases is crucial.

Case report: Castleman’s disease involving the renal sinus resembling renal cell carcinoma

“…CD rarely affects extrathoracic presentations, with even fewer presentations in the renal sinus. To the best of our knowledge, only a few cases have been reported (8)(9)(10)(11)(12)(13)(14)(15)(16). The clinicopathological features of the reported cases are shown in Table 1.…”

Inflammatory Pseudotumor of Castleman Disease and IgG4-related Disease Masquerading as Kidney Malignancy

“…Moreover, radiation therapy can be considered in those unsuitable for surgery (30). Contrastingly, surgery is insu cient for the management of MCD with lower overall survival rate than UCD (21,31). The management of MCD is mainly based on glucocorticoids, chemotherapy, antiretroviral therapy, and monoclonal antibody therapy targeting IL-6 (30).…”

Pénfigo paraneoplásico como presentación atípica de la enfermedad de Castleman

“…La enfermedad de Castleman constituye un raro trastorno linfoproliferativo que fue descrito por primera vez hace más de 60 años como una masa benigna y localizada (6). Desde el punto de vista clínico esta enfermedad ha sido dividida en dos subtipos: EC unicéntrica (ECU) y EC multicéntrica (ECM).…”