Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2019; 7(24): 4391-4397
Published online Dec 26, 2019. doi: 10.12998/wjcc.v7.i24.4391
Castleman disease in the hepatic-gastric space: A case report
Xiao-Yun Xu, Xue-Qing Liu, Hong-Wei Du, Jian-Hua Liu
Xiao-Yun Xu, Hong-Wei Du, Department of Gastroenterology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Xue-Qing Liu, Jian-Hua Liu, Department of Hepatobiliary Surgery, Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Author contributions: Xu XY, Liu XQ, Du HW, and Liu JH wrote and revised the manuscript; all authors read and approved the final manuscript.
Informed consent statement: The patient gave informed consent.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The manuscript was revised according to the CARE checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jian-Hua Liu, PhD, Professor, Department of Hepatobiliary Surgery, Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang 050000, Hebei Province, China. dr.ljh@outlook.com
Received: September 29, 2019
Peer-review started: September 29, 2019
First decision: November 19, 2019
Revised: November 27, 2019
Accepted: November 30, 2019
Article in press: November 30, 2019
Published online: December 26, 2019
Processing time: 83 Days and 2.8 Hours
Abstract
BACKGROUND

Castleman disease, also known as giant lymph node hyperplasia, was first reported in 1956. It is a rare benign proliferative pathological change of the lymph nodes.

CASE SUMMARY

The patient, a 33-year-old woman, had epigastric distension for half a year. Examinations were performed in a local hospital. Computed tomography scan showed round soft tissue nodules, about 5.45 cm in diameter, in the hepatic-gastric space. Endoscopic ultrasound and endoscopic ultrasound guided fine needle aspiration was performed on the patient. Rapid on-site evaluation, hematoxylin eosin staining and histopathology of the puncture smear was performed. According to the Diff-Quik staining and hematoxylin eosin staining results of preoperative endoscopic ultrasound guided fine needle aspiration puncture smears as well as the immunohistochemistry results, Castleman disease was highly suspected. A sufficient preoperative evaluation was made, and a precise surgical plan was developed. Postoperative pathology confirmed Castleman disease.

CONCLUSION

Endoscopic ultrasound guided fine needle aspiration can extract internal tissues of the tumor for histological and cytological examinations and provide accurate diagnosis as much as possible. Therefore, a sufficient preoperative evaluation can be made, and a precise surgical plan can be developed.

Keywords: Castleman disease; Hepatic-gastric space; Endoscopic ultrasound; Endoscopic ultrasound guided fine needle aspiration; Rapid on-site evaluation; Case report

Core tip: Castleman disease, also known as giant lymph node hyperplasia, is a rare benign proliferative pathological change of the lymph nodes. This study reports a case of Castleman disease in a 33-year-old woman who was referred to our hospital for an enhanced computed tomography examination after prior examinations in a local hospital. Although enhanced computed tomography and magnetic resonance imaging scans have some characteristic manifestations, they still lack specificity. A gold standard for the pathological diagnosis is still required. Endoscopic ultrasound guided fine needle aspiration, which can extract internal tissues of the tumor for histological and cytological examinations, can provide an accurate diagnosis.