J Korean Surg Soc. 2009 Feb;76(2):127-130. Korean.
Published online Feb 28, 2009.
Copyright © 2009 The Korean Surgical Society
Case Report

Laparoscopic Treatment of Mesenteric Castleman's Disease

Yu Sun Cha, M.D., Hyung Rae Kim, M.D., Say June Kim, M.D., Sang Chul Lee, M.D., Jeong Goo Kim, M.D., Dong Ho Lee, M.D., Chang Joon Ahn, M.D., Dae Hyun Baek, M.D.,1 and Kwan Ju Lee, M.D.
    • Department of Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Daejeon, Korea.
    • 1Department of Pathology, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Daejeon, Korea.
Received June 09, 2008; Accepted August 21, 2008.

Abstract

Castleman's disease (CD) is an uncommon lymphoproliferative disorder of unknown origin. There are two histological types: hyaline-vascular type and plasma cell type. CD is usually located in the mediastinum, but may be seen in any site including the neck, axilla, mesentery, and retroperitoneum. A 52-year-old male complained of vague lower abdominal pain. There was no palpable mass and all laboratory data showed nonspecific findings. Abdominal computed tomography scan showed a solitary homogenous, well-defined mass in the mesentery. The laparoscopic complete resection was performed without complications. Histologic examination of resected lesion revealed the hyaline-vascular type of CD. In the hyaline-vascular type of CD, laparoscopic approach constitutes a complete treatment. We present here the case of laparoscopic treatment of isolated mesenteric CD.

Keywords
Castleman's disease; Mesentery; Hyaline-vascular type; Laparoscopic treatment

Figures

Fig. 1
Abdominal computed tomography revealed the finding of homogeneous and well-enhancing mass (white arrow).

Fig. 2
Laparoscopy shows the tumor (black arrow) located in the mesenteric root.

Fig. 3
Gross finding of the resected specimen. The mass shows a 2.5×2 cm in size solid mass with homogenous cut surface.

Fig. 4
Microscopic finding of the specimen. (A) Some follicles with marked vascular proliferation and hyalinization. (H&E, ×40). (B) Germinal center with hyalinization and a tight concentric layering of lymphocytes. (onion-skin appearance) (H&E, ×200).

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