Mesenteric Castleman disease: Two case reports and review of literature

Castleman disease (CD) is a rare lymphoproliferative disorder most commonly occurring in the mediastinum and hilar regions. Mesenteric involvement is rare, and diagnosis primarily relies on histopathological examination.

We report two cases of mesenteric CD with gastrointestinal symptoms accompanied by weight loss. Case 1 underwent complete surgical resection of the lesion. Postoperative pathology confirmed the hyaline vascular type, and the prognosis was favorable. Case 2 also underwent complete surgical resection initially, with postoperative pathology confirming the plasma cell type. However, the disease followed an aggressive course. A second surgery was performed five months later, and postoperative pathology confirmed mesenteric peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). The patient died postoperatively due to acute renal failure.

To our knowledge, this is the first reported case of mesenteric CD transforming into PTCL-NOS, highlighting the complexity and heterogeneity of the clinical course of mesenteric CD. These findings provide insights into the personalized treatment and clinical management of this disease.