Korean J Urol.  2009 Apr;50(4):413-416.

Castleman Disease Misdiagnosed as a Neoplasm of the Kidney

• Ryu JH
• Oh JW
• Kim KH
• Choi JI
• Ryu KH
• Kim YJ
• Jung TY

Abstract

Castleman disease, or angiofollicular lymph node hyperplasia, is a fairly rare benign tumor of lymphoid origin. Most cases tend to present as a mediastinal mass. We report a 58-year-old man with Castleman disease of the right perirenal space. This case was diagnosed preoperatively as nonconventional renal cell carcinoma (RCC) or renal oncocytoma because the enhancing mass abutted the renal cortex. The patient underwent a radical nephrectomy and a histopathological analysis showed the unicentric plasma cell type of Castleman disease. A preoperative diagnosis of Castleman disease is difficult; therefore, a surgical resection and a histological evaluation can provide an accurate diagnosis of this tumor. Taking this case into consideration, we suggest that Castleman disease should be included in the differential diagnosis of renal tumors.

Keyword

Giant lymph node hyperplasia; Plasma cells

MeSH Terms

Adenoma, Oxyphilic
Carcinoma, Renal Cell
Diagnosis, Differential
Giant Lymph Node Hyperplasia
Humans
Kidney
Kidney Neoplasms
Middle Aged
Nephrectomy
Plasma Cells
Adenoma, Oxyphilic
Kidney Neoplasms

Figure

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  Fig. 1 CT scan showing a well-defined enhancing mass at the medial cortex of the right kidney (arrow). Arterial phase (A) and delayed phase (B).

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  Fig. 2 Macroscopic view of the resected kidney. There is a 1.8×1.5×1.0 cm ovoid mass in the hilar soft tissue (arrow).

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  Fig. 3 Plasma cell type of Castleman disease. Microscopically, the interfollicular area contains a sheet of plasma cells [H&E, ×200 (A), ×400 (B)].

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