J Korean Surg Soc.  2009 Feb;76(2):127-130. 10.4174/jkss.2009.76.2.127.

Laparoscopic Treatment of Mesenteric Castleman's Disease

• Cha YS
• Kim HR
• Kim SJ
• Lee SC
• Kim JG
• Lee DH
• Ahn CJ
• Baek DH
• Lee KJ

• KMID: 2211274
• DOI: http://doi.org/10.4174/jkss.2009.76.2.127

Abstract

Castleman's disease (CD) is an uncommon lymphoproliferative disorder of unknown origin. There are two histological types: hyaline-vascular type and plasma cell type. CD is usually located in the mediastinum, but may be seen in any site including the neck, axilla, mesentery, and retroperitoneum. A 52-year-old male complained of vague lower abdominal pain. There was no palpable mass and all laboratory data showed nonspecific findings. Abdominal computed tomography scan showed a solitary homogenous, well-defined mass in the mesentery. The laparoscopic complete resection was performed without complications. Histologic examination of resected lesion revealed the hyaline-vascular type of CD. In the hyaline-vascular type of CD, laparoscopic approach constitutes a complete treatment. We present here the case of laparoscopic treatment of isolated mesenteric CD.

Keyword

Castleman's disease; Mesentery; Hyaline-vascular type; Laparoscopic treatment

MeSH Terms

Abdominal Pain
Axilla
Giant Lymph Node Hyperplasia
Humans
Lymphoproliferative Disorders
Male
Mediastinum
Mesentery
Middle Aged
Neck
Plasma Cells

Figure

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  Fig. 1 Abdominal computed tomography revealed the finding of homogeneous and well-enhancing mass (white arrow).

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  Fig. 2 Laparoscopy shows the tumor (black arrow) located in the mesenteric root.

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  Fig. 3 Gross finding of the resected specimen. The mass shows a 2.5×2 cm in size solid mass with homogenous cut surface.

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  Fig. 4 Microscopic finding of the specimen. (A) Some follicles with marked vascular proliferation and hyalinization. (H&E, ×40). (B) Germinal center with hyalinization and a tight concentric layering of lymphocytes. (onion-skin appearance) (H&E, ×200).

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