Skip to main content

Advertisement

SpringerLink
Log in

Castleman’s disease of the mesorectum: Report of a case

  • Case Report
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Castleman’s disease is a benign lymphoid proliferative disorder, which most commonly presents as a solitary mass in the mediastinum, although extrathoracic sites have been reported in the neck, axilla, pelvis, mesentery, pancreas, and retroperitoneum. We report a case of asymptomatic, isolated Castleman’s disease in the mesorectum, which is extremely rare. The patient was a 34-year-old woman who underwent investigations for vaginal spotting. A presacral mass was located on the left side of the rectum, 10 cm from the anal verge. Contrast-enhanced computed tomography showed a large, well-demarcated, strongly enhancing mass with internal radiating septa in the mesorectum. The mass was well circumscribed and isointense to muscle on T1-weighted magnetic resonance imaging, appearing as a slightly hyperintense mass on T2-weighted imaging. We performed laparoscopic mesorectal mass excision, and histological examination revealed features typical of the hyaline-vascular type of Castleman’s disease. Thus, when a mesorectal mass is being investigated, Castleman’s disease should be considered in the differential diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Castleman B, Towne VW. Case records of the Massachusetts General Hospital: case no. 40231. N Engl J Med 1954;250:1001–1005.

    Article  CAS  PubMed  Google Scholar 

  2. Keller AR, Hochholzer L, Castleman B. Hyaline-vascular and plasma-cell types of giant lymph node hyperplasia of the mediastinum and other locations. Cancer 1972;29:670–683.

    Article  CAS  PubMed  Google Scholar 

  3. Okada S, Maeta H, Maeba T, Goda F, Mori S. Castleman disease of the pararenal retroperitoneum: report of a case. Surg Today 1999;29:178–181.

    Article  CAS  PubMed  Google Scholar 

  4. Kumar B, Kumar M, Sen R, Anchal N. Mature solid teratoma of the rectum: report of a case. Surg Today 2008;38:1133–1136.

    Article  PubMed  Google Scholar 

  5. Jao SW, Beart RW Jr., Spencer RJ, Reiman HM, Ilstrup DM. Retrorectal tumors. Mayo Clinic experience, 1960–1979. Dis Colon Rectum 1985;28:644–652.

    Article  CAS  PubMed  Google Scholar 

  6. Uhlig BE, Johnson RL. Presacral tumors and cysts in adults. Dis Colon Rectum 1975;18:581–589.

    Article  CAS  PubMed  Google Scholar 

  7. Stewart RJ, Humphreys WG, Parks TG. The presentation and management of presacral tumours. Br J Surg 1986;73:153–155.

    Article  CAS  PubMed  Google Scholar 

  8. Hata T, Ikeda M, Ikenaga M, Yasui M, Shingai T, Yamamoto H, et al. Castleman’s disease of the rectum: report of a case. Dis Colon Rectum 2007;50:389–394.

    Article  PubMed  Google Scholar 

  9. Castleman B, Iverson L, Menendez VP. Localized mediastinal lymphnode hyperplasia resembling thymoma. Cancer 1956;9:822–830.

    Article  CAS  PubMed  Google Scholar 

  10. Lowenthal DA, Filippa DA, Richardson ME, Bertoni M, Straus DJ. Generalized lymphadenopathy with morphologic features of Castleman’s disease in an HIV-positive man. Cancer 1987;60:2454–2458.

    Article  CAS  PubMed  Google Scholar 

  11. Frizzera G. Castleman’s disease and related disorders. Semin Diagn Pathol 1988;5:346–364.

    CAS  PubMed  Google Scholar 

  12. Lee IJ, Kim SC, Kim HS, Bang D, Yang WI, Jung WH, et al. Paraneoplastic pemphigus associated with follicular dendritic cell sarcoma arising from Castleman’s tumor. J Am Acad Dermatol 1999;40:294–297.

    Article  CAS  PubMed  Google Scholar 

  13. Chorzelski T, Hashimoto T, Maciejewska B, Amagai M, Anhalt GJ, Jablonska S. Paraneoplastic pemphigus associated with Castleman tumor, myasthenia gravis and bronchiolitis obliterans. J Am Acad Dermatol 1999;41:393–400.

    Article  CAS  PubMed  Google Scholar 

  14. Dargent JL, Delplace J, Roufosse C, Laget JP, Lespagnard L. Development of a calcifying fibrous pseudotumour within a lesion of Castleman disease, hyaline-vascular subtype. J Clin Pathol 1999;52:547–549.

    Article  CAS  PubMed  Google Scholar 

  15. Lachant NA, Sun NC, Leong LA, Oseas RS, Prince HE. Multicentric angiofollicular lymph node hyperplasia (Castleman’s disease) followed by Kaposi’s sarcoma in two homosexual males with the acquired immunodeficiency syndrome (AIDS). Am J Clin Pathol 1985;83:27–33.

    CAS  PubMed  Google Scholar 

  16. Vasef M, Katzin WE, Mendelsohn G, Reydman M. Report of a case of localized Castleman’s disease with progression to malignant lymphoma. Am J Clin Pathol 1992;98:633–636.

    CAS  PubMed  Google Scholar 

  17. Caussinus E, Meggetto F, Delsol G, Brousset P. Simultaneous occurrence of Epstein-Barr virus associated Hodgkin’s disease and HHV-8 related multicentric Castleman’s disease: a fortuitous event? J Clin Pathol 2001;54:790–791.

    CAS  PubMed  Google Scholar 

  18. Matsushima AY, Hamele-Bena D, Osborne BM. Fine-needle aspiration biopsy findings in marginal zone B cell lymphoma. Diagn Cytopathol 1999;20:190–198.

    Article  CAS  PubMed  Google Scholar 

  19. Hsu SM, Waldron JA, Xie SS, Barlogie B. Expression of interleukin-6 in Castleman’s disease. Hum Pathol 1993;24:833–839.

    Article  CAS  PubMed  Google Scholar 

  20. Bowne WB, Lewis JJ, Filippa DA, Niesvizky R, Brooks AD, Burt ME, et al. The management of unicentric and multicentric Castleman’s disease: a report of 16 cases and a review of the literature. Cancer 1999;85:706–717.

    Article  CAS  PubMed  Google Scholar 

  21. Shroff VJ, Gilchrist BF, DeLuca FG, McCombs HL, Wesselhoeft CW. Castleman’s disease presenting as a pediatric surgical problem. J Pediatr Surg 1995;30:745–747.

    Article  CAS  PubMed  Google Scholar 

  22. Seco JL, Velasco F, Manuel JS, Serrano SR, Tomas L, Velasco A. Retroperitoneal Castleman’s disease. Surgery 1992;112:850–855.

    CAS  PubMed  Google Scholar 

  23. Mandler RN, Kerrigan DP, Smart J, Kuis W, Villiger P, Lotz M. Castleman’s disease in POEMS syndrome with elevated interleukin-6. Cancer 1992;69:2697–2703.

    Article  CAS  PubMed  Google Scholar 

  24. Weichenthal M, Stemm AV, Ramsauer J, Mensing H, Feller AC, Meigel W. POEMS syndrome: cicatricial alopecia as an unusual cutaneous manifestation associated with an underlying plasmacytoma. J Am Acad Dermatol 1999;40:808–812.

    Article  CAS  PubMed  Google Scholar 

  25. Demirpolat G, Pourbagher A, Hekimgil M, Elmas N, Kitis O, Korkut M, et al. Mesenteric Castleman’s disease: case report. Abdom Imaging 2000;25:551–553.

    Article  CAS  PubMed  Google Scholar 

  26. Shin JH, Lee HK, Kim SY, Khang SK, Park SH, Choi CG, et al. Castleman’s disease in the retropharyngeal space: CT and MR imaging findings. Am J Neuroradiol 2000;21:1337–1339.

    CAS  PubMed  Google Scholar 

  27. Ferreiros J, Gomez Leon N, Mata MI, Casanova R, Pedrosa CS, Cuevas A. Computed tomography in abdominal Castleman’s disease. J Comput Assist Tomogr 1989;13:433–436.

    Article  CAS  PubMed  Google Scholar 

  28. Glazer M, Rao VM, Reiter D, McCue P. Isolated Castleman disease of the neck: MR findings. Am J Neuroradiol 1995;16:669–671.

    CAS  PubMed  Google Scholar 

  29. Luburich P, Nicolau C, Ayuso MC, Torra R, Clavero JA. Pelvic Castleman disease: CT and MR appearance. J Comput Assist Tomogr 1992;16:657–659.

    CAS  PubMed  Google Scholar 

  30. Frizzera G. Castleman’s disease: more questions than answers. Hum Pathol 1985;16:202–205.

    Article  CAS  PubMed  Google Scholar 

  31. Weisenburger DD, Nathwani BN, Winberg CD, Rappaport H. Multicentric angiofollicular lymph node hyperplasia: a clinicopathologic study of 16 cases. Hum Pathol 1985;16:162–172.

    Article  CAS  PubMed  Google Scholar 

  32. Marti S, Pahissa A, Guardia J, Moragas A, Bacardi R. Multicentric giant follicular lymph node hyperplasia. Favorable response to radiotherapy. Cancer 1983;51:808–810.

    Article  CAS  PubMed  Google Scholar 

  33. Summerfield GP, Taylor W, Bellingham AJ, Goldsmith HJ. Hyaline-vascular variant of angiofollicular lymph node hyperplasia with systemic manifestations and response to corticosteroids. J Clin Pathol 1983;36:1005–1011.

    Article  CAS  PubMed  Google Scholar 

  34. Chen CH, Liu HC, Tung KY, Lee JJ, Liu CL, Liu TP. Surgical outcome of superficial and deep Castleman disease. ANZ J Surg 2007;77:339–343.

    Article  PubMed  Google Scholar 

  35. Chronowski GM, Ha CS, Wilder RB, Cabanillas F, Manning J, Cox JD. Treatment of unicentric and multicentric Castleman disease and the role of radiotherapy. Cancer 2001;92:670–676.

    Article  CAS  PubMed  Google Scholar 

  36. Bjarnason I, Cotes PM, Knowles S, Reid C, Wilkins R, Peters TJ. Giant lymph node hyperplasia (Castleman’s disease) of the mesentery. Observations on the associated anemia. Gastroenterology 1984;87:216–223.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Colorectal Cancer, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 411-769, Republic of Korea

    Mi Ri Hwang, Hee Jin Chang, Guh Jung Seo, Sang Bum Yoo, Ji Won Park, Hyo Seong Choi & Jae Hwan Oh

  2. Department of Radiology, Center for Clinical Service, Research Institute & Hospital, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 411-769, Republic of Korea

    Min Ju Kim

Authors
  1. Mi Ri Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hee Jin Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Min Ju Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Guh Jung Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sang Bum Yoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ji Won Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hyo Seong Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jae Hwan Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hwang, M.R., Chang, H.J., Kim, M.J. et al. Castleman’s disease of the mesorectum: Report of a case. Surg Today 41, 271–275 (2011). https://doi.org/10.1007/s00595-009-4206-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-009-4206-3

Key words

Search

Navigation