Report of two cases of Castleman’s Disease: a case of benign localizeddisease and a case of fast progressive multicentric disease

Abstract

Castleman’s Disease is a rare tumour involving lymph node tissues; a case of benign localized disease and a case of rapid progressive multicentric disease are reported. Case report 1: A 19-year-old man presented with four months of hypogastric and left iliac pain. Castleman’s Disease was suspected after CT-scan. A CT-guided fine-needle biopsy of the lesion was performed revealing hyaline vascular type Castleman’s Disease. The patient underwent open surgery with radical excision of the lesion. No adjuvant therapy was performed after surgery. The patient is alive and disease-free after 24 months. Case report 2: A 58-year-old woman presented with a right axillary palpable lymph node and vague abdominal discomfort. Abdomen CT demonstrated hepatosplenomegaly associated with adenopathy at the hepatic hilus and splenic hilus; dilatation of intra-hepatic biliary ducts was present. The axillary node was excised, the mass at hepatic hilus was biopsied. The diagnosis was Castleman’s Disease in both sites. In course of steroid therapy retroperitoneal multiple nodes appeared associated with fast-progressive mechanic jaundice and liver failure. Progressive multi-organ failure arose within 1 week, with irreversible clinical worsening to death.