Castleman disease mimicked pancreatic carcinoma: report of two cases
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Castleman disease mimicked pancreatic carcinoma: report of two cases Hua Guo1,2,3, Yan Shen1,2,3, Wei-Lin Wang1,2,3, Min Zhang1,2,3, Hong Li1,2,3, Ying-Sheng Wu1,2,3, Sheng Yan1,2,3, Xiao Xu1,2,3, Jian Wu1,2,3 and Shu-Sen Zheng1,2,3*
Abstract Castleman disease (CD) is an uncommon benign lymphoproliferative disorder, which usually presents as solitary or multiple masses in the mediastinum. Peripancreatic CD was rarely reported. Herein, we report two cases of unicentric peripancreatic CD from our center. A 43-year-old man and a 58-year-old woman were detected to have a pancreatic mass in the routine medical examinations. Both of them were asymptomatic. The computed tomography and ultrasonographic examination revealed a mild enhancing solitary mass at the pancreatic head/ neck. No definite preoperative diagnosis was established and Whipple operations were originally planned. The intraoperative frozen section diagnosis of both patients revealed lymphoproliferation. Then the local excisions of mass were performed. Histological examination revealed features of CD of hyaline-vascular type. No recurrence was found during the follow-up period. CD should be included in the differential diagnosis of pancreatic tumors. Local excision is a suitable surgical choice. Keywords: Castleman disease, Peripancreatic tumor, Hyaline-vascular type
Background Castleman disease (CD) is an uncommon benign lymphoproliferative disorder of unknown etiology. It was first described by Castleman in 1956 [1]. There are three pathologic variants: hyaline vascular CD, plasma cell CD, and mixed type of CD is characterized that a patient had features of both hyaline vascular and plasma cell types of CD [2]. Plasmablastic variant of CD, which was considered as a subvariant of plasma cell type, occurs predominantly in immunosuppressed patients and human immunodeficiency virus (HIV)-positive patients [3]. Clinically, CD may present in the forms of unicentric and multicentric. The unicentric variant of CD (UCD) is the most common form of the disease, which is confined to a single lymph-node chain or area, with hyaline vascular type. It is often asymptomatic and curable by surgical excision of the mass. The multicentric variant of CD (MCD) is a less common but more aggressive form. * Correspondence: [email protected] 1 Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery First Affliliated Hospital,School of Medicine, Zhejiang University, 79 Qingchun Street, Zhejiang Province, Hangzhou 310003, China 2 Key laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, 79 Qingchun Street, Zhejiang Province, Hangzhou 310003, China Full list of author information is available at the end of the article
Its corresponding histological pattern is usually the plasma cell and mixed type [3]. Unicentric peripancreatic CD was rarely reported in the published literature. Herein, we report two cases of unicentric peripancreatic CD of hyaline vascular type from our cent
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