Fine‐needle aspiration cytology of Castleman disease: Case report with review of the literature

Abstract

Organs involved by Castleman disease (CD) may be investigated by fine-needle aspiration cytology. No specific cytomorphological criteria are currently described for a definitive diagnosis. The cytological features of three fine-needle aspirations from three different lymph nodes of a patient with histologically confirmed CD of the hyaline-vascular type are herein reported, with a review of the literature. The fine-needle aspirations showed branching capillaries associated with fragments of germinal center. Review of the literature yielded 12 other case reports with over half describing similar findings. Because branching hyalinized small blood vessels penetrating follicular germinal center are characteristic of CD of the hyaline-vascular type on histology, this finding in fine-needle aspirates should raise that diagnostic possibility.

Castleman's disease of a submandibular mass diagnosed on Fine Needle Cytology: Report of a case with histopathological, immunocytochemical and imaging correlations

“…However, FNA remains rather underutilized for the evaluation of lymphadenopathy, partially due to the lack of available expertise for the performance and interpretation of such samples (21). Several authors have emphasised the diagnostic importance of FNC in CD (35,36). Although only case reports are available in the literature, attempts have been made to describe the cytomorphological findings in CD (37-42) which can be indicative enough for it to be considered preoperatively, among other entities.…”

Cytological diagnosis of Castleman′s disease of the soft tissue

“…[8] to a set of cytomorphological criteria that could help in the identification of this condition on aspirate smears. After review, the following cytomorphological criteria were suggested to be indicators of the lesion: (i) The presence of large oval to round cells having ill-defined cytoplasmic margins and large nuclei with irregular nuclear outlines having fine or coarse chromatin, giving a crumpled tissue paper appearance; (ii) a polymorphous population of lymphoid cells predominantly of small lymphocytes in the background.…”

“…The authors concluded that although hyaline-vascular CD is a difficult diagnostic entity on aspirate material, the presence of large histiocytic cells with a crumpled tissue paper appearance of the nuclei in a background of small lymphocytes is a useful indicator for suspecting this lesion. [8] However, these findings should be analyzed in larger studies to determine if they could in anyway reduce the diagnostic dilemma in cases of CD.…”

“…[8] reported that the FNACs in three cases showed branching capillaries associated with fragments of germinal center. A review of literature by them yielded 12 other case reports with over half describing similar findings.…”

Intrathoracic Castleman's disease: “An important clinical mimicker”

“…[12] Further, a lesser degree of the enhancement is found in the plasma cell variant. [13] CT-guided fine-needle aspiration (FNA) of the mass is usually nondiagnostic in both UCD and MCD and are frequently “negative for malignant cells.”[291011] According to Deschênes et al .,[14] FNA can be useful in diagnosing some cases of CD, but in author's opinion, excision biopsy should be preferred whenever possible.…”