Unicentric Castleman disease was misdiagnosed as pancreatic mass: A case report

Abstract

BACKGROUND Castleman’s disease (CD) is a lymphatic proliferative disorder of unknown cause and is rarely seen clinically. It has been divided into unicentric and multicentric types. Unicentric CD (UCD) occurs as a solitary enlarged mass and mediastinal lymph nodes are the most common site. Surgical excision has proven to be curative for UCD. Multicentric CD (MCD) appears as a systemic disease with peripheral lymphadenopathy. MCD had a poor response to surgery and monoclonal antibodies with rituximab have become a research hotspot. CASE SUMMARY A 44-year-old woman presented with a pancreatic mass during routine physical examination. She had no obvious symptoms, such as fever, abdominal pain, abdominal distension, or jaundice. Ultrasound examination indicated a hypoechoic mass between the body of the pancreas, left lobe of the liver and stomach. It had a clear boundary, irregular shape, uneven echo, and no obvious blood flow signals. To clarify the diagnosis, contrast-enhanced ultrasound examination was performed, which showed a benign pancreatic lesion. Neuroendocrine or solid pseudopapillary tumor was a possible diagnosis. The patient underwent further contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging, which were suggestive of solid pseudopapillary tumor or neuroendocrine tumor. All the examinations failed to give a definitive diagnosis, and the patient underwent surgery. The final pathological and immunohistochemical results showed that the mass was CD. CONCLUSION This case highlights when lymphadenopathy is encountered clinically, CD should be considered and a biopsy should be performed.

Castleman disease of the pancreas mimicking pancreatic neuroendocrine tumor: A rare case report

“…CD affecting the pancreas is very rare [ 14 ]. In most cases, the tumor is suspected preoperatively based on radiology and is diagnosed postoperatively based on histopathology [ 3 , 15 ]. To the best of our knowledge, this is the first reported case of chromogranin A (CgA) positive pancreatic CD.…”

Case Report: A rare case of primary hepatic Castleman’s disease mimicking a liver tumor

“…UCD occurs most commonly in the mediastinum, cervical regions, and abdominal/pelvic cavity but can be found in any lymph node station ( 1 ). Rarely, UCD occurs in the lung ( 4 ), kidney ( 5 ), orbit ( 6 ), parotid gland ( 7 ), spleen ( 8 ), accessory spleen ( 9 ), small intestine ( 10 ), pancreas ( 11 ), porta hepatis ( 12 ), and adrenal gland ( 13 ). However, a focal Castleman’s disease located in the liver is extremely rare.…”