Peripancreatic Castleman Disease

Context Castleman disease or giant lymph node hyperplasia is a rare disorder of thelymphoid tissue, usually occurring in the mediastinum. We report a case of localizedperipancreatic plasma cell type Castleman disease, which is an unusual site.Case report A 45-year-old woman with a history of mild epigastric pain radiating to theback for the previous year was admitted and her physical examination was normal. Araised erythrocyte sedimentation rate, Creactive  protein and hypergammaglobulinemia were found. Abdominal ultrasonography and magnetic resonance imaging demonstrated a homogeneously hypoechoic solid mass having a smooth-surface, 6 cm in diameter,located between the head of the pancreas, the lower margin of the antrum and the left lobeof the liver. The mass was totally excised surgically with repair of the pancreas capsule. Histopathological examination of the tumor showed plasma-cell type Castleman disease.Conclusion Clinicians should be aware that Castleman disease may involve peripancreatictissue which leads to difficulties in arriving at a differential diagnosis. Surgical excision isboth a diagnostic and a curative method for management of the disease.