Castleman's disease arising from the gallbladder neck causing difficulty in the differential diagnosis

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Castleman's disease is a rare lymphoproliferative disorder.
• Gallbladder malignancies can present with similar symptoms, complicating diagnosis.
• Castleman's disease of the gallbladder is exceptionally rare.

Purpose of the Study:

• To report the first detailed case of Castleman's disease originating in the gallbladder neck.
• To highlight diagnostic challenges in differentiating this rare condition from gallbladder cancer.
• To describe the successful surgical management and long-term outcome.

Main Methods:

• A 50-year-old woman presented with epigastric pain.
• Imaging studies (CT, MRCP) revealed a gallbladder neck tumor, suspicious for malignancy.
• Surgical resection (cholecystectomy) with frozen section analysis was performed for definitive diagnosis and treatment.

Main Results:

• Histopathology confirmed unicentric Castleman's disease, hyaline vascular variant, in the gallbladder neck.
• The tumor showed lymphoid tissue proliferation without dysplasia.
• The patient remained recurrence-free 28 months post-surgery.

Conclusions:

• Castleman's disease can mimic gallbladder malignancies, posing significant diagnostic challenges.
• Surgical intervention is crucial for definitive diagnosis and treatment of gallbladder Castleman's disease.
• This case underscores the importance of considering rare entities in the differential diagnosis of gallbladder masses.