Case report
Incidentally Detected Castleman Disease of the Thorax and its Surgical Management: A Case Report
PD06-PD08
Correspondence
Dr. Sudhansoo Khanna,
Assistant Professor, Cardiovascular and Thoracic Surgery, Department of General Surgery, Government Medical College and Hospital (GMCH-32), Sector-32, Chandigarh-160030, Union Territory, India.
E-mail: sudhansoo_84@yahoo.com
Castleman Disease (CD) is a rare lymphoproliferative disorder, the aetiology and pathogenesis of which remain unclear. It most commonly presents as a localised form, known as Unicentric CD (UCD), and less frequently as a generalised form, termed Multicentric CD (MCD). The thorax is the most common site of UCD; however, due to its rarity, UCD is seldom included in the differential diagnosis of an intrathoracic mass. Preoperative identification of CD is challenging. On imaging, CD typically appears as a well-defined, homogeneous mass. A characteristic feature of UCD on Contrast-Enhanced CT (CECT) is intense enhancement during the arterial phase, which decreases in the portal venous phase. This intense enhancement is attributed to the hypervascular nature of UCD. Therefore, multiphase CECT may be considered the investigation of choice when UCD is suspected. The lesion is highly vascular and often exhibits dense adhesions with adjacent organs, making surgical resection challenging. Authors report a case of a posterior mediastinal mass located in the left paraspinal region, which was incidentally detected in a 53-year-old female. The mass was successfully resected via a left postero-lateral thoracotomy and was postoperatively diagnosed on Histopathological Examination (HPE) as Castleman Disease, Hyaline Vascular Variant (HVV). The postoperative course was uneventful. Preoperative suspicion of CD would aid surgeons in planning the procedure appropriately and help avoid unexpected findings during surgery.