A Rare Diagnosis of Nasal Mass:Castleman's Disease

Castleman disease (CD) is a rare disease of lymph nodes and related tissues. The disease can occur anywhere in the body where lymphoid tissue is normally present. Mediastinum is the most common site of involvement (approximately 70%) followed by the neck (15%) and the abdomen (15%) but extra lymphatic sites such as lungs, larynx, parotid glands, pancreas, meninges can be involved. Localised nasopharyngeal CD is extremely rare and to our knowledge the present case is the only case reported originating from the nasal cavity per se. According to literature only 4 cases of CD in nasopharynx has been reported till date. Microscopic subtypes are hyaline vascular, plasma cell, mixed, plasmablastic type. Hyaline vascular is the most common (90%) histological subtype. Four other cases were reported earlier, in which the nasopharynx was the site of origin. Our case had histopathologic features consistent with a mixture of plasma cell and hyaline vascular variant CD, while the previous four reported cases were of hyaline vascular type, making ours the first of its kind.