[Castleman's lymphoma presenting marked bronchial obstruction and compression of the great vessels: a case report]

A 24-year-old Caucasian male from Chile developed mediastinal Castleman's lymphoma, hyaline-vascular type, occupying from upper pre-tracheal to sub-carinal region, severely compressing the trachea, left main bronchus, pulmonary artery, and pericardium. Bronchofiberscopy demonstrated complete obstruction of the left main bronchus and the severe telangiectasis of the mucosa. The patient complained of the stridor and shortness of breath. The left thoracotomy had been performed in Chile, but unsucceeded in extirpation because of the adherence and the hypervascularity of the tumor. After 24 Gy irradiation, we performed the right thoracotomy and succeeded in extirpation of the tumor. It was the key for success that we could approach from right side under left sided unilateral ventilation. Castleman's lymphoma is not a rare disease, but the manifestation due to the bronchial obstruction is uncommon. So we present this case and review the literatures.