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22 November 2010

Castleman’s disease in a patient with inguinal mass mimicking hernia

Hamidreza Seifmanesh, Mohammadreza Hafezi-Ahmadi, Monireh Yaghoubi, Hadi Peyman

Am J Case Rep 2010; 11:211-213 :: ID: 881262

Abstract

Background: Hernias comprise approximately 7% of all surgical outpatient visits, and occur more commonly in the groin. Inguinal hernia is a protrusion of abdominal cavity contents through the inguinal canal. It is very common in surgery, and lifetime risk is reported to be 27% for men and 3% for women. Castleman’s is a rare disease, characterized clinically by hypertrophy of lymph nodes and histologically by angiofollicular lymph node hyperplasia. It may occur throughout the lifespan from adolescence to the seventh decade.
Case Report: A 27-year-old workman was referred to the emergency department for left inguinal pain with increasing severity when standing and walking. Except for nausea and vomiting, he had no other symptoms. Upon palpation, a left inguinal, hard and tender mass was found. Laboratory data and chest X-ray were normal. A total surgical excision was performed under general anesthesia. Histological assessment revealed an extensive capillary proliferation and a lymphocyte predominant infiltrate surrounded by small germinal centers, confirming Castleman’s disease.
Conclusions: Considering the importance of differential diagnosis of inguinal hernia, Castleman’s disease can mimic the signs and symptoms of inguinal hernia, and it should be considered in suspected cases of inguinal mass.

Keywords: Castleman disease, lymphadenopathy, inguinal hernia

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923