Castleman's disease is an uncommon lymphoproliferative disorder. There are three histologic types, hyaline vascular (the most common), plasma cell variant and mixed form. The hyaline vascular variant is typically characterized by a benign clinical course without constitutional symptoms (localized disease). It is usually managed with surgery and/or radiotherapy. Multicentric disease is a systemic disorder. An optimal management is still unknown. We report a case of a 47-year-old man with an abdominal mass and compressive symptom. After partial surgical resection, histopathological and immunohistological studies revealed the hyaline vascular variant of localized Castleman's disease. Because the follicular cells were CD20+ we administered rituximab (anti-CD20 monoclonal antibody). Most of the cases reviewed do not consider this approach, except for HHV-8 and sarcoma of Kaposi associated multicentric Castleman's disease. They usually consider the patient free from disease after surgical resection of localized Castleman's disease, but there is a risk of developing non-Hodgkin lymphoma in the long-term. The purpose of this report is to present this rare case, to stress that Castleman's disease should be included in the differential diagnosis of lymphoid disorders and to discuss the management of this disorder.
Castleman's disease; abdominal mass; rituximab
