いわゆる混合型の組織像を呈した縦隔発生限局型Ｃａｓｔｌｅｍａｎ病の１例

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  • A CASE OF LOCALIZED CASTLEMAN'S DISEASE OF THE MIXED TYPE IN THE MEDIASTINUM

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A 19-year-old man showed an abnormal shadow in the right superior mediastinum on a chest X-ray film. On admission, labolatory data showed anemia and a rise in CRP level. Chest CT scan revealed a 4-cm, well circumscribed right paratracheal mass. Enhanced magnetic resonance imaging scan showed a marginal enhancement. It was diagnosed as an inflammatory bronchogenic cyst and thoracoscopic surgery was performed. Complete excision of the tumor was performed without difficulty. After the surgery his laboratory abnormalities returned to normal ranges. Histopathologically, the tumor which was solid and pale yellow in color was diagnosed as mixed type of Castleman's disease. Cases of localized Castleman's disease are predominantly of hyaline vascular type and rarely of plasma cell or mixed type. Although patients with hyaline vascular type are mostly asymptomatic, those with plasma cell type or mixed type often present with systemic symptoms and abnormal laboratory data. We report a rare case of localized Castleman's disease of the mixed type.

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