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Unicentric Castleman’s Disease Presenting as a Pulmonary Mass: A Diagnostic Dilemma

Badi Rawashdeh, Mark Meyer, Dong Yimin, Colon Anthony, Duy Nguyn, Mohammad Moslemi, Simin Golestani, Sobonya Richard, Samuel Kim

(Division of Cardiothoracic Surgery, University of Arizona Medical Center, Tucson, AZ, USA)

Am J Case Rep 2015; 16:259-261

DOI: 10.12659/AJCR.893380

Background: Castleman’s disease, or angiofollicular lymphoid hyperplasia, is a rare disorder and can be easily misdiagnosed as lymphoma, neoplasm, or infection. The diagnosis is challenging due to the nonspecific signs and symptoms as well as the rarity of the disease. We present an unusual case of a young girl presenting with an enlarging pulmonary mass that was believed to be infectious in origin.
Case Report: A 16-year-old Native American female from Arizona initially presented with occasional non-productive cough and chest pain. Imaging revealed a 3-cm left upper lobe lobulated mass. This mass was thought to be due to coccidioidomycosis and was treated with fluconazole. Follow-up imaging demonstrated growth of the mass to 4.8 cm. The patient underwent a left video-assisted thoracoscopic left upper lobectomy and mediastinal lymphadenectomy. Histopathological examination revealed Castleman’s disease.
Conclusions: Pulmonary masses in young patients can be easily misdiagnosed as infections or cancer. We present the case of a 16-year-old female misdiagnosed as having a fungal infection of the lung, which was later revealed to be Castleman’s disease of the left upper lobe.

Keywords: Diagnosis, Differential, Biopsy, Adolescent, Giant Lymph Node Hyperplasia - diagnosis, Lung Diseases - diagnosis, Lymph Nodes - pathology, Tomography, X-Ray Computed

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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