Abstract
Castleman disease (CD) is a rare lymphoproliferative disorder, the
etiology and pathogenesis of which is not clearly established. It
presents more commonly as a localised disease or unicentric CD (UCD),
and less often as generalised disease or multricentric CD (MCD). The
most common site of UCD is in the thorax; however, UCD is rarely
included in the differential diagnosis of an intrathoracic mass due to
its rarity. The lesion is highly vascular and often has dense adhesions
with adjacent organs, making the surgery a difficult task.
We report a case of posterior mediastinal mass located in left
paraspinal region which was detected incidentally in a 53-year old
female and was subsequently resected successfully via left
postero-lateral thoracotomy, and was diagnosed post-operatively on
histopathological examination (HPE) as CD, hyaline vascular variant
(HVV). We review the relevant clinical, pathological and radiological
findings of CD, which may act as clinical pointers for establishing a
preoperative diagnosis of CD. Suspecting CD preoperatively would guide
the surgeon for appropriate surgical planning and may avoid facing such
surprise on the operating table.
Keywords: Castleman disease, lymphoproliferative disorder,
posterior mediastinal mass, incidental diagnosis