Multicentric hyaline-vascular Castleman's disease in the retroperitoneum

Castleman's disease is a rare lymphoproliferative disease of unknown cause. Most multicentric cases described have been of the plasma-cell variety. This article presents a case of multicentric hyaline-vascular Castleman's disease in the retroperitoneum with the ultrasonographic and computed tomography (CT) imaging manifestations.

During routine physical examination, a mass was detected in the left abdomen of a 53-year-old man with no signs or symptoms. The patient underwent ultrasound-guided aspiration biopsy and operative excision after laboratory examination, ultrasonography, and CT.

Ultrasonography demonstrated a dominant hypoechogenic mass with hypervascularity in the retroperitoneum. CT detected a relatively homogenous enhanced lesion and several satellite nodules. After the mass and several lymph nodes were resected, histopathologic examination demonstrated a lymphocyte-predominant infiltrate surrounding the germinal centres and extensive capillary proliferation, consistent with the hyaline-vascular type of Castleman's disease. The patient received postoperative chemotherapy and remained free of recurrence 3 months later.

Ultrasonography and contrast-enhanced CT can provide a positive differential diagnosis of hyaline-vascular Castleman's disease which is a kind of giant lymph node hyperplasia with hypervascularity.