Korean J Urol.  2008 Feb;49(2):186-189.

Retroperitoneal Castleman's Disease Incidentally Detected due to Urinary Calculus

• Lee JW
• Park SY
• Kim BS
• Kim SJ
• Son YW
• Moon HS
• Park CK
• Lee TY

Abstract

Castleman's disease(CD) is a rare benign tumor characterized by hyperplasia of lymphoid tissue. It can occur in almost any l ocation, with 70% in the mediastinum, 7% in the retroperitoneum, and only 2% in the perirenal area. Approximately 80% of primary retroperitoneal tumors are malignant, so tumor resection and differential diagnosis with other retroperitoneal tumors is important. We present a case of a hyaline-vascular type CD in the pararenal area, detected incidentally during evaluation of a urinary calculus, with a review of the literature.

Keyword

Castleman's disease; Retroperitoneum; Neoplasms

MeSH Terms

Diagnosis, Differential
Giant Lymph Node Hyperplasia
Hyperplasia
Lymphoid Tissue
Mediastinum
Urinary Calculi

Figure

• 

  Fig. 1. Intravenous pyelography (IVP) shows a small urinary calculus of the right ureterovesical junction (white arrow). The right ureter was tilted laterally because of the mass effect (black arrow).

• 

  Fig. 2. CT scan of the abdomen shows a well-defined enhancing mass (8x5 cm) with a non-homogenous, low density portion on the back of the vena cava at the level of renal hilum. The vena cava is pushed forward by the mass (white arrow).

• 

  Fig. 3. (A) Grossly, the excised mass is well-circumscribed, with a solid gray cut surface, measured 8x6.5x5 cm and weighed 155 g. (B) Microscopically, there are prominent germinal centers showing well-developed vascular hyaline changes (H&E, x100) (white arrows).

Reference

1. Castleman B, Iverson L, Menendez VP. Localized mediastinal lymphnode hyperplasia resembling thymoma. Cancer. 1956; 9:822–30.

2. Aygun C, Tekin MI, Demirhan B, Peskircioglu CL, Agildere M, Ozkardes H. A case of incidentally detected Castleman's disease with retroperitoneal paravertebral localization. Int J Urol. 2000; 7:22–5.

3. Bucher P, Chassot G, Zufferey G, Ris F, Huber O, Morel P. Surgical management of abdominal and retroperitoneal Castleman's disease. World J Surg Oncol. 2005; 3:33.

4. Kim HC, Lee BG, Nam YJ, Cho SJ, Kim ME, Park YH. A case of retroperitoneal Castleman's disease. Korean J Urol. 1994; 35:190–3.

5. Hsu HH, Chen YC, Fang JT, Huang CC, Shih LY, Ghuang CK. Unicentric Castleman's disease associated with hydronephrosis. Urology. 2000; 56:856.

6. 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; 29:670–83.

7. Dham A, Peterson BA. Castleman disease. Curr Opin Hematol. 2007; 14:354–9.

8. Kim JS, Lee SH, Kim HJ, Han SW, Lee HM, Lee KH, et al. A case of retroperitoneal Castleman's disease. Korean J Urol. 1997; 38:1387–90.

9. Seco JL, Velasco F, Manuel JS, Serrano SR, Tomas L, Velasco A. Retroperitoneal Castleman's disease. Surgery. 1992; 112:850–5.

10. Kim YJ, Kim JH, Lee SJ, Kim JI. Hyaline-vascular variant of Castleman's disease in retroperitoneum. Korean J Urol. 2001; 42:668–70.