Perigastric Hyaline-Vascular Variant Castleman’s Disease

Abstract

Castleman disease (CD) is a rare chronic lymphoproliferative disease with unknown etiology and pathogenesis disease. When the lesion is located in the mediastinum, the diagnosis of CD is easy. However, if the lesion presents as a perigastric mass mimicking other subserosal gastric mesenchymal tumors, the diagnosis can be challenging. As few sonographic manifestations of hyaline-vascular variant CD, especially contrast-enhanced ultrasound (CEUS) imaging, as well as computed tomography (CT) and histopathological imaging, have been reported in literature, this case may provide a vivid example of a comprehensive CEUS and CT usage in the diagnosis and surgery with regard to CD. This report presents a case of a 50-year-old female diagnosed with hyaline-vascular variant CD in a random physical examination, the ultrasound examination first revealed a 24.3 mm × 15.4 mm hypoechogenic lesion abutting the stomach, esophagus, and liver, which was under the suspicion of gastrointestinal stromal tumor. Following a series of medical examinations, including CEUS, CT, postoperative histopathological examination, and immunohistochemical analysis, the patient was diagnosed with hyaline-vascular variant unicentric CD. After the mass was completely excised through laparoscopic surgery, the woman recovered very well without recurrence during a follow-up period of 15 months. Thus, mastering ultrasound and CT-imaging characteristics of CD and applying ultrasound and CT examination together would do help to preoperative diagnosis.

Clinicopathological characteristics of gastric IgG4‐related disease: Systematic scoping review

“…While rare, Castleman disease (CD), an important mimicker of IgG4-RD, can also present as a gastric mass. 48 A thorough workup with serology, including serum immunoglobulin A and M, and C-reactive protein, may help rule out lymphoproliferative diseases, including CD. 49 Currently, it is unclear if gastric IgG4-RD can increase the risk of gastric malignancy.…”

“…Our results suggest that patients with gastric IgG4‐RD have a high likelihood to present with solitary gastric lesions, which poses a challenge to clinicians given the broad differential diagnosis. While rare, Castleman disease (CD), an important mimicker of IgG4‐RD, can also present as a gastric mass 48 . A thorough workup with serology, including serum immunoglobulin A and M, and C‐reactive protein, may help rule out lymphoproliferative diseases, including CD 49 …”