A Case of Peripancreatic Castleman's Disease of Hyaline Vascular Type
1)Department of Surgery, Aizu Central Hospital
2)Department of Surgery, Nippon Medical School
Castleman's disease, also known as giant lymph node hyperplasia or angiofollicular lymph node hyperplasia, is a rare and poorly understood disease characterized by massive growth of lymphoid tissue. We report a case of peripancreatic Castleman's disease of the hyaline vascular type.
A 56-year-old man with a history of back pain was referred to the Gastroenterological Center in our hospital. A surveillance abdominal computed tomography (CT) scan demonstrated a well-circumscribed enhancing mass measuring 3.2×3.1 cm within the body of the pancreas. A nonfunctioning pancreatic endocrine tumor was suspected; therefore, surgery was performed. Only tumor enucleation was performed, because the tumor appeared well circumscribed and encapsulated on intraoperative ultrasonography findings. Histopathological examination showed that the tumor was composed of multiple lymph follicles with concentric layers of mantle zone cells, showing an "onion skin" appearance and atrophic germinal centers. The germinal centers had penetrating arterioles with hyalinized vessel walls.
This is a benign disease and good prognosis is obtained by simple tumor enucleation. In this case, it was difficult to diagnose Castleman's disease before surgery. Surgical excision is a diagnostic as well as curative method for management of this disease. Moreover, we could remove the tumor without resecting any other organs by using intraoperative ultrasonography.
日医大医会誌 2015; 11(2), 105-109
Castleman disease, hyaline-vascular type, pancreatic tumor
Kazumitsu Cho, Department of Surgery, Kitamurayama Hospital, 2-15-1 Onsenmachi, Higashine, Yamagata 999-3702