Intrathoracic Castleman disease

Authors: PINAR BIÇAKÇIOĞLU, SELİM ŞAKİR ERKMEN GÜLHAN, LEYLA NESRİN ACAR, YETKİN AĞAÇKIRAN, ŞEREF ÖZKARA, SADİ KAYA, NURETTİN KARAOĞLANOĞLU

Abstract: To analyze patients with Castleman disease who were diagnosed by surgery. Materials and methods: We retrospectively investigated the postoperative pathological records of operations performed between January 1992 and December 2012 in our hospital. Files of 19 patients with the diagnosis of Castleman disease were analyzed. Results: There were 13 male and 6 female patients with a mean age of 40.1 ± 11.4 (range: 20-57) years. Fifteen thoracotomies and 3 video-assisted thoracoscopies, 12 on the right side and 6 on the left side, and 1 mediastinoscopy were performed. Biopsies and mass excisions were performed in 2 and 17 cases, respectively. Histopathological findings were hyaline vascular-type (n = 16), plasma cellular-type (n = 2), and hyaline vascular plus plasma cellular-type (n = 1) Castleman disease. Conclusion: Castleman disease can occur in all areas of the thorax, but the mediastinum and hilum are the most common locations. Surgical excision is the best method of diagnosis and treatment. Complete excision is curative for local forms of the disease. However, complete excision may not be possible at all times due to local invasion and hypervascularization. Multimodal treatment, including chemotherapy, is recommended in patients with a multicentric form of the disease, and they should be followed closely.

Keywords: Castleman disease, mediastinum, lung, surgery

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