Castleman's disease in a kidney failure patient diagnosed incidentally during transplantation

Castleman's disease is a rare lymphoid disorder. It comprises two pathological entities. These are the hyaline-vascular type which is usually localized (uni-centeric) and the plasma-cell type which is usually multicenteric and rather aggressive.

Here we present a 53 years old Sudanese male who underwent kidney transplantation in August 2009 from a related live-donor. During transplantation, he was accidently found to have an abnormal looking lymph node at the site of the graft bed. The lymph node was totally excised and sent for histopathology. Based on the histopathological examination, the diagnosis of Castleman's disease of the hyaline vascular type was made. The patient gained normal graft function and was maintained on tacrolimus, azathioprine and prednisolone. He maintained normal graft function for more than twelve months post transplantation with a serum creatinine level of 0.9 mg/dl. He remained free from recurrence of Castleman's disease during the follow up period.

Unicenteric Castleman's disease may be completely asymptomatic. Surgical excision of the lesion was curative for our patient despite maintenance on immunosuppression.