Primary Castleman's disease in the liver: A case report and literature review

Abstract

Abstract. Castleman's disease (CD) is a lymphoproliferative abnormality, also referred to as giant lymph node hyperplasia or follicular lymphoid hyperplasia. The occurrence of CD in the liver is rare. Radiological diagnosis of hepatic CD by computed tomography (CT) and magnetic resonance imaging (MRI) remains difficult. On imaging, hepatic CD is often expressed as a single, well-defined soft tissue lesion, with rare cystic degeneration and focal necrosis. The CD lesions appear as hypervascular with abundant cell proliferation on CT and MRI. Polymorphic calcification is commonly identified in the lesion. However, these findings are non-specific for a definitive radiological diagnosis. We herein present a case of hepatic CD and review its pathological and imaging characteristics. In particular, a strip-like area was observed extending from the nodule, which may be helpful for the diagnosis of CD in the liver.

Hyaline Vascular Type of Unicentric Castleman Disease in a Kidney with End-Stage Renal Disease: A Case Report of a Rare Entity at an Unusual Location and a Special Clinical Setting

“…CD has been diagnosed within variable primary sites, including the mediastinal, intra-abdominal, cervical, axillary, retroperitoneal or inguinal lymph nodes [ 7 , 15 ]. Rarely, UCD presents in unusual sites, such as the lungs, orbits, mouth, tonsil, nasopharynx, liver and small intestine [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. Single-site involvement of renal parenchyma is extremely rare in this disease, with only a little relevant literature published.…”

Pure large cell neuroendocrine carcinoma originating from the endometrium: A case report

“…Most tumors had high mitotic activity, areas of necrosis, and vascular invasion and expressed at least one neuroendocrine marker (chromogranin, synaptophysin, or CD56)[ 14 , 15 ]. The Ki-67 proliferation index was very high (> 80%)[ 16 , 17 ]. Immunohistochemical staining of four cases of pure LCNEC, three cases of LCNEC associated with endometrioid carcinoma, and one case of small cell neuroendocrine carcinoma associated with endometrioid carcinoma demonstrated abnormalities of mismatch repair protein expression[ 14 ].…”

Primary hepatic Castleman disease

“…It was first described in the 1950s by pathologist Benjamin Castleman when he identified localised mediastinal lymph node enlargement that was histologically different from the thymoma he suspected 2. Through emerging research over the past 70 years, CD has been found to comprise at least four disorders that have characteristic histopathological features, but variable aetiology, presentation, treatment and prognosis 3. CD is broadly classified in terms of its location, unicentric or multicentric nature and its histological features.…”

“…Unicentric disease involves a single enlarged lymph node or lymph node region, whereas multicentric disease involves several lymph node stations 3. Histologically, Castleman first discovered the hyaline vascular subtype, characterised by lymphoid follicles with germinal centre regression or involution and hypervascular capillary proliferation.…”

“…A. Flendrig discovered the plasma cell variant, which is characterised by enlarged follicular cells with abundant mature plasma cells in the absence of hypervascularity or angiogenesis 4. Recent research has demonstrated that the histological pattern of CD exists on a spectrum and that intermediate or mixed histopathological variants are common 3. In managing patients with CD, it is important to identify the subtype, because treatment and prognosis are highly variable.…”