Head and Neck Pathology

, Volume 7, Issue 4, pp 389–392

Castleman Disease in the Parapharyngeal Space: A Case Report and Review of the Literature

  • Jason B. Clain
  • Sophie Scherl
  • William E. Karle
  • Azita Khorsandi
  • Violette Ghali
  • Beverly Wang
  • Mark L. Urken
Sine qua non Radiology-Pathology


Castleman disease is most commonly found in the mediastinum, while the head and neck is the second most common location. The disease exists in a unicentric and multicentric variety and is usually successfully treated with surgical resection alone. Early identification is important for treatment planning. Castleman disease has been reported to mimic other disease processes, however there has been only one report of the disease mimicking a nerve sheath tumor in the parapharyngeal space. Here we report the second case of Castleman disease mimicking a schwannoma in the parapharyngeal space.


Head and neck Otolaryngology Radiology Schwannoma Mimicking Castleman disease Parapharyngeal space tumor Lymphoproliferative 


  1. 1.
    Adrian YY, Becker TS, Rice DH. Giant lymph node hyperplasia of the head and neck (Castleman’s disease): a report of five cases. OtolaryngologyHead and Neck. Surgery. 1995;113(4):462–6.Google Scholar
  2. 2.
    Castleman B, Iverson L, Menendez VP. Localized mediastinal lymph-node hyperplasia resembling thymoma. Cancer. 2006;9(4):822–30.CrossRefGoogle Scholar
  3. 3.
    Flendrig J. Benign giant lymphoma: clinicopathologic correlation study. The year book of cancer. 1970. p. 296–299.Google Scholar
  4. 4.
    Dispenzieri A. Castleman disease. Rare hematological malignancies. 2008. p. 293–330.Google Scholar
  5. 5.
    Bowne WB, Lewis JJ, Filippa DA, et al. The management of unicentric and multicentric Castleman’s disease. Cancer. 1999;85(3):706–17.PubMedCrossRefGoogle Scholar
  6. 6.
    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(3):670–6.PubMedCrossRefGoogle Scholar
  7. 7.
    Dispenzieri A, Gertz MA. Treatment of Castleman’s disease. Curr Treat Options Oncol. 2005;6(3):255–66.PubMedCrossRefGoogle Scholar
  8. 8.
    Yildirim H, Cihangiroglu M, Ozdemir H, Kabaalioglu A, Yekeler H, Kalender O. Castleman’s disease with isolated extensive cervical involvement. Australas Radiol. 2005;49(2):132–5.PubMedCrossRefGoogle Scholar
  9. 9.
    Bonekamp D, Horton KM, Hruban RH, Fishman EK. Castleman disease: the great mimic. Radiographics. 2011;31(6):1793–807.PubMedCrossRefGoogle Scholar
  10. 10.
    Finn MA, Schmidt MH. Castleman disease of the spine mimicking a nerve sheath tumor. J Neurosurg: Spine. 2007;6(5):455–9.CrossRefGoogle Scholar
  11. 11.
    Stevens EA, Strowd RE, Mott RT, Oaks TE, Wilson JA. Angiofollicular lymph node hyperplasia resembling a spinal nerve sheath tumor: a rare case of Castleman’s disease. Spine J: Offici J North Am Spine Soc. 2009;9(9):e18.CrossRefGoogle Scholar
  12. 12.
    Karakoc O, Kilic E, Ilica T, Tosun F, Hidir Y. Castleman disease as a giant parapharyngeal mass presenting with dysphagia. J Craniofac Surg. 2011;22(6):e54.PubMedCrossRefGoogle Scholar
  13. 13.
    Oksenhendler E, Duarte M, Soulier J, et al. Multicentric Castleman’s disease in HIV infection: a clinical and pathological study of 20 patients. AIDS (Lond, Eng). 1996;10(1):61.Google Scholar
  14. 14.
    Ide C, Coene BD, Lawson G, Betsch C, Trigaux J. Castleman’s disease in the neck: MRI. Neuroradiology. 1997;39(7):520–2.PubMedCrossRefGoogle Scholar
  15. 15.
    Weng C-H, Chen J-B, Wang J, Wu C–C, Yu Y, Lin T-H. Surgically curable non-iron deficiency microcytic anemia: castleman’s disease. Onkologie. 2011;34(8–9):456–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Yoshizaki K, Matsuda T, Nishimoto N, et al. Pathogenic significance of interleukin-6 (IL-6/BSF-2) in Castleman’s disease. Blood. 1989;74(4):1360–7.PubMedGoogle Scholar
  17. 17.
    Leger-Ravet M, Peuchmaur M, Devergne O, et al. Interleukin-6 gene expression in Castleman’s disease. Blood. 1991;78(11):2923–30.PubMedGoogle Scholar
  18. 18.
    Nishimoto N, Sasai M, Shima Y, et al. Improvement in Castleman’s disease by humanized anti-interleukin-6 receptor antibody therapy. Blood. 2000;95(1):56–61.PubMedGoogle Scholar
  19. 19.
    Nishimoto N, Kanakura Y, Aozasa K, et al. Humanized anti–interleukin-6 receptor antibody treatment of multicentric Castleman disease. Blood. 2005;106(8):2627–32.PubMedCrossRefGoogle Scholar
  20. 20.
    McAdams HP, Rosado-de-Christenson M, Fishback NF, Templeton PA. Castleman disease of the thorax: radiologic features with clinical and histopathologic correlation. Radiology. 1998;209(1):221–8.PubMedGoogle Scholar
  21. 21.
    Newlon J, Couch M, Brennan J. Castleman’s disease: three case reports and a review of the literature. Ear Nose Throat J. 2007;86(7):414.PubMedGoogle Scholar
  22. 22.
    Shahidi H, Myers JL, Kvale PA. Castleman’s disease. Paper presented at: Mayo clinic proceedings 1995.Google Scholar
  23. 23.
    Tomita T, Ozawa H, Sakamoto K, Ogawa K, Kameyama K, Fujii M. Diagnosis and management of cervical sympathetic chain schwannoma: a review of 9 cases*. Acta Otolaryngol. 2009;129(3):324–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Wax MK, Shiley SG, Robinson JL, Weissman JL. Cervical sympathetic chain schwannoma. Laryngoscop. 2004;114(12):2210–3.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Jason B. Clain
    • 1
  • Sophie Scherl
    • 1
  • William E. Karle
    • 1
    • 5
  • Azita Khorsandi
    • 3
    • 5
  • Violette Ghali
    • 4
  • Beverly Wang
    • 4
  • Mark L. Urken
    • 1
    • 2
  1. 1.Thyroid Head and Neck Cancer FoundationNew YorkUSA
  2. 2.Department of OtolaryngologyBeth Israel Medical CenterNew YorkUSA
  3. 3.Department of RadiologyBeth Israel Medical CenterNew YorkUSA
  4. 4.Department of PathologyBeth Israel Medical CenterNew YorkUSA
  5. 5.Albert Einstein College of MedicineNew YorkUSA

Personalised recommendations