A rare case of unicentric plasma cell type Castleman's disease in the mediastinum

Castleman's disease is a very rare (and thus little-known) lymphoproliferative disorder characterized by lymph node follicular hyperplasia with abnormal interfollicular vascular growth. It can be classified into unicentric and multicentric variants according to its localization, and into three histological types: hyaline-vascular, plasma cell and mixed. We describe the case of a 51 year-old woman who presented with precordial chest pain. Chest X-Ray and computed tomography (CT) raised the suspicion of an aortic aneurysm, and the patient was sent to the Interventional Cardiology Clinic at the Military Emergency Clinical Center for Cardiovascular Diseases (CCUBCVA), where the diagnosis of mediastinal tumor was made by ultrasonography, coronarography and CT. The patient was transferred to our clinic, where a diagnostic mediastinoscopy proved histolopathologically inconclusive. A lateral thoracotomy with ideal tumorectomy was decided upon and carried out, and the diagnosis of plasma cell type Castleman's disease was established. This paper discusses the pathogenic mechanisms, symptoms, diagnosis and treatment of Castleman's disease.