CASE REPORT

JOP. J Pancreas (Online) 2004; 5(6):491-494.

Peripancreatic Castleman Disease

Nazif Erkan1, Mehmet Yildirim1, Elif Selek2, Sehnaz Sayhan2

1Department of 2nd Surgery and 2Department of Pathology, SSK Izmir Training Hospital. Izmir, Turkey

ABSTRACT

Context Castleman disease or giant lymph node hyperplasia is a rare disorder of the lymphoid tissue, usually occurring in the mediastinum. We report a case of localized peripancreatic plasma cell type Castleman disease, which is an unusual site.

Case report A 45-year-old woman with a history of mild epigastric pain radiating to the back for the previous year was admitted and her physical examination was normal. A raised erythrocyte sedimentation rate, C-reactive protein and hypergammaglobulinemia were found. Abdominal ultrasonography and magnetic resonance imaging demonstrated a homogeneously hypoechoic solid mass having a smooth-surface, 6 cm in diameter, located between the head of the pancreas, the lower margin of the antrum and the left lobe of the liver. The mass was totally excised surgically with repair of the pancreas capsule. Histopathological examination of the tumor showed plasma-cell type Castleman disease.

Conclusion Clinicians should be aware that Castleman disease may involve peripancreatic tissue which leads to difficulties in arriving at a differential diagnosis. Surgical excision is both a diagnostic and a curative method for management of the disease.

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Keywords Diagnosis, Differential; Diagnostic Imaging; Giant Lymph Node Hyperplasia; Pancreas; Pancreatic Diseases; Surgical Procedures, Operative

Correspondence Nazif Erkan: naziferkan2002@hotmail.com