[A case of Castleman's disease that recurred nine years after initial surgical removal]

Castleman's disease (CD) is a lymphoproliferative disorder with resemblance in histopathology of thymoma. Here we describe a 48-year-old man with bloody sputum and a mass lesion of the right hilum on chest roentgenogram. He had undergone an incomplete surgical removal of a mediastinal tumor nine years earlier, which proved to be CD with characteristics of hyaline-vascular type pathology. The regrown mass lesion as well as the right upper and middle lobes were removed surgically. Histological examination of the tumor specimen revealed characteristics of hyaline-vascular type CD which were nearly identical to those of the tumor removed nine years earlier. Recurrence of CD as observed in the present report is very uncommon, since only 5 cases, including this one, have been reported. We suggest that in CD the primary tumor as well as regional lymph nodes should be completely removed, and the patients should be kept under long-term postoperative observation to check for recurrence.