Obstet Gynecol Sci.  2015 Jul;58(4):323-326. 10.5468/ogs.2015.58.4.323.

Pelvic Castleman's disease presenting as an adnexal tumor in a young woman

• Lee J
• Paek J
• Lee YH
• Kong TW
• Chang SJ
• Ryu HS

• KMID: 2314055
• DOI: http://doi.org/10.5468/ogs.2015.58.4.323

Abstract

Castleman's disease (CD) is a rare benign disorder of unknown etiology characterized by proliferation of lymphoid tissues. Seventy percent of this tumor occurs in the mediastinum and it is seldom found in neck, pancreas or pelvis. We report a case of asymptomatic pelvic CD initially presenting as an adnexal tumor in a 27-year-old woman. Initial transvaginal sonography revealed 7-cm-sized hyperechoic mass adjacent to the right ovary and the following abdominal computed tomography scanning showed the same sized mass located on the right extraperitoneal pelvic cavity. Laparoscopic mass excision was performed without any complication and pathological diagnosis was made as CD. CD should be included in the differential diagnosis of female pelvic masses which are noted in the pelvic cavity. In this report, we review the clinicopathological findings in a presentation of CD.

Keyword

Adenxal tumor; Giant lymph node hyperplasia; Pelvis

MeSH Terms

Adult
Diagnosis
Diagnosis, Differential
Female
Giant Lymph Node Hyperplasia*
Humans
Lymphoid Tissue
Mediastinum
Neck
Ovary
Pancreas
Pelvis

Figure

• 

  Fig. 1 About 7-cm-sized mass at right extraperitoneal pelvis. (A) Transvaginal ultrasonography. (B,C) Abdominopelvic computed tomography. (D) Intraoperative finding.

• 

  Fig. 2 Microscopic examination showing Castleman's disease representing hyaline-vascular type. (A) Multiple lymph node hyperplasia (HE, ×200). (B) Hyalinized germinal center (HE, ×400).

Reference

1. Castleman B, Towne VW. Case records of the Massachusetts General Hospital: case no. 40231. N Engl J Med. 1954; 250:1001–1005.

2. Castleman B, Iverson L, Menendez VP. Localized mediastinal lymphnode hyperplasia resembling thymoma. Cancer. 1956; 9:822–830.

3. Keller AR, Hochholzer L, Castleman B. Hyaline-vascular and plasma-cell types of giant lymph node hyperplasia of the mediastinum and other locations. Cancer. 1972; 29:670–683.

4. Ebara S, Song SN, Mizuta H, Ito Y, Hasegawa K, Kamata T, et al. Interleukin-6-producing dermoid cyst associated with multicentric Castleman's disease. Int J Hematol. 2012; 95:198–203.

5. Hsieh CH, Changchien CC, Lan KC, Huang CC, Shen CC, Chang SY, et al. Pelvic Castleman's disease presenting as an adnexal tumor. Acta Obstet Gynecol Scand. 2004; 83:311–313.

6. Nakamura Y, Tokuyama O, Muso A, Kawamura N, Yasui T, Ishiko O. Asymptomatic pelvic Castleman disease in an infertile woman: case report. Arch Gynecol Obstet. 2004; 269:156–158.

7. Oksenhendler E, Duarte M, Soulier J, Cacoub P, Welker Y, Cadranel J, et al. Multicentric Castleman's disease in HIV infection: a clinical and pathological study of 20 patients. AIDS. 1996; 10:61–67.

8. Frizzera G. Castleman's disease: more questions than answers. Hum Pathol. 1985; 16:202–205.

9. Hsu SM, Waldron JA, Xie SS, Barlogie B. Expression of interleukin-6 in Castleman's disease. Hum Pathol. 1993; 24:833–839.

10. Cronin DM, Warnke RA. Castleman disease: an update on classification and the spectrum of associated lesions. Adv Anat Pathol. 2009; 16:236–246.

11. Saeed-Abdul-Rahman I, Al-Amri AM. Castleman disease. Korean J Hematol. 2012; 47:163–177.

12. Nishi J, Arimura K, Utsunomiya A, Yonezawa S, Kawakami K, Maeno N, et al. Expression of vascular endothelial growth factor in sera and lymph nodes of the plasma cell type of Castleman's disease. Br J Haematol. 1999; 104:482–485.

13. Baser I, Dilek S, Pabuccu R, Ulgenalp I, Mermut S, Finci R. Unexpected nature of a pelvic mass in pregnancy: Castleman's disease. Gynecol Obstet Invest. 1989; 28:53–55.

14. Schwartz A, Eid A, Sasson T, Cohen P, Durst AL, Rivkind AI. Pelvic giant lymph node hyperplasia (Castleman's disease): a surgical and radiological approach. Eur J Surg. 1996; 162:993–996.

15. Riba PO. Castleman's disease: angiofollicular benign lymph-node hyperplasia. Radiological features in the differential diagnosis of vascular tumours of the pelvis. Br J Radiol. 1979; 52:412–414.