Castleman disease (CD) is a rare disorder characterized by nonspecific clinical presentations and imaging findings, making it prone to misdiagnosis and missed diagnosis. This report details the diagnosis and treatment process of a patient with CD complicated by rheumatoid arthritis (RA) who developed chylous leakage postoperatively, highlighting the potential risks of infection and nutritional depletion, aiming to enhance the understanding of CD.

A patient with CD complicated by RA developed chylous leakage postoperatively, which posed risks of infection and nutritional depletion.

The patient underwent a left axillary lymph node excisional biopsy on November 13, 2019, and was diagnosed with HV-CD based on pathology.

No further axillary lymph node dissection or adjuvant therapy was performed. Postoperatively, the patient developed significant chylous leakage from the biopsy incision, which resolved after 2 weeks of drainage, dietary modifications, and anti-infective treatment.

Follow-up showed no disease progression, and the chylous leakage resolved with appropriate management.

A history of RA may be associated with the onset of CD. HV-CD generally has a favorable prognosis, and chylous leakage post-axillary lymph node biopsy, though rare, can be effectively managed with appropriate drainage, dietary control, and infection prevention.

Castleman's disease (CD) is characterised by benign lymphoepithelial proliferation and is a peculiar form of angiofollicular lymph node hyperplasia rather than a neoplasm or a hamartoma. CD is broadly classified as unicentric CD (UCD) and multicentric CD. In the unicentric variant, patients have localised disease affecting only a single lymph node or a group of adjacent nodes in a single region, which clinically presents as an enlarging mass without any other significant symptoms. The mediastinum and thoracic lymph nodes are commonly involved. However, it is uncommon for CD to occur in the pelvic presacral region of the retroperitoneum. A 31-year-old male presented with progressive, dull aching, intermittent lower abdomen pain for three months with no aggravating or relieving factors or any associated symptoms. He was haemodynamically stable, and his general physical examination was normal. An abdominal examination elicited mild tenderness in the left iliac region of the abdomen. Contrast-enhanced computed tomography of the abdomen and pelvis revealed an encapsulated nodal mass with intralesional calcification displacing the bladder to the right side, and fine needle aspiration cytology showed atypical cells. An exploratory laparotomy was performed with an in toto excision biopsy of the pelvic retroperitoneal mass, and it was diagnosed as a hyaline-vascular variant of UCD. Immunohistochemistry revealed angiofollicular hyperplasia and atretic germinal centres that are crossed by sclerotic vessels and hyalinisation, confirming the diagnosis. The patient is currently asymptomatic and is leading a routine life. The hyaline-vascular variant is the most common variant seen in UCD. Compared to the multicentric type, the unicentric type seldom exhibits systemic involvement. Surgical resection is typically curative. Although it is asymptomatic, it is essential to achieve complete surgical resection to prevent the neoplastic potentialities of CD. In the presence of an uncertain solitary solid pelvic retroperitoneal mass, the diagnosis of UCD should be considered, as surgical resection can achieve a favourable outcome.

Castleman disease (CD) is a benign lymphoproliferative disorder of unknown etiology, which can involve any part of the body. CD can involve a single lymph node (unicentric) or multiple lymph nodes (multicentric) of which unicentric CD is the most common type. The unicentric CD is usually localized, asymptomatic, and often appears as an incidental mass on radiographs, whereas multicentric CD is characterized by systemic involvement. Mesenteric involvement of CD is very rare. In this article, we present a case of the unicentric CD of small bowel mesentery, which mimicked a neuroendocrine tumor preoperatively.

Castleman's disease is an uncommon benign lymphoproliferative disorder that commonly involves the mediastinum. We report an unusual case that involves the presentation of unicentric Castleman's disease in a 52-year-old female. The patient had a supraclavicular mass extending onto the brachial plexus. The approach to the treatment and plan for supraclavicular masses is complex due in part to the extensive list of differential diagnoses possible. In this case specifically, while the mass was ultimately determined to be benign, post-surgery, the location of the mass intraoperatively made for a very technically challenging and complex dissection. Post surgical resection, the patient reported no complications. This case highlights the importance of clinical judgement, imaging and surgical technique in removing a mass encroaching on the brachial plexus.

Castleman's disease is a rare disease characterized by benign lymphoepithelial proliferation. There are two forms: unicentric and multicentric Castleman's disease. Mediastinal location is the most frequent. Intra-abdominal Castleman's disease is a rare presentation. We report a case of 65-year-old female who presented with epigastric pain. Investigations revealed a retroperitoneal mass which was surgically resected. Histopathological examination showed hyaline-vascular type Castleman's disease. In conclusion, Castelman´s disease is a diagnostic challenge and it must be included in the differential diagnosis of retroperitoneal tumors.

Castleman disease (CD) is a rare lymphoproliferative disorder that presents with various symptoms. CD accompanied with jaundice is uncommon since there are only 11 cases reported in the literature.

Here we report a 62-year-old woman who was admitted to the hospital with signs and symptoms of intermittent jaundice. Biochemical tests showed higher serum levels of total and direct bilirubin, and normal serum levels of tumor markers and interleukin-6. Contrast-enhanced computed tomography detected a 6 cm × 4 cm × 2.5 cm mass between the hepatoduodenal ligament and the inferior vena cava. The mass was successfully excised and the patient had a complete resolution of symptoms. A diagnosis of idiopathic unicentric CD was made based upon histological examination, which demonstrated the pathological features of CD of mixed type, including hyperplasia of follicular lymphoids with abundant plasma cells, degenerative germinal centers, interfollicular vascularity and hyaline degeneration. The diagnosis was corroborated by immunohistochemical analysis which detected multiple biomarkers.

This is the first study that describes the clinicopathological features of CD presenting with jaundice, which may deepen and extend our understanding of this disease.