腎臟Castleman氏病之特殊案例報告

陳生文、蕭毅君、薛又仁、黃建榮、賴昱維、邱文祥

台北市立聯合醫院仁愛院區外科部泌尿科

台北市立聯合醫院忠孝院區外科部泌尿科

Castleman’s Disease Mimicking Renal Cell Carcinoma: A Case Report

Sheng-Wen Chen, Yi-Chun Hsiao, Thomas Y. Hsueh, Andy C. Huang, Yu-Wei Lai, Allen W. Chiu

Division of Urology, Department of Surgery, Taipei City Hospital Renai branch

Division of Urology, Department of Surgery, Taipei City Hospital Zhongxiao branch

Introduction:

Castleman’s disease, a rare type of benign proliferation of lymphoid tissue, was categorized into plasma cell and hyaline-vascular type. Hyaline vascular type composed nearly 90% of Castleman’s disease, which usually represents unicentric, asymptomatic mass lesion with benign course. We presented a 63-year-old male with left renal Castleman’s disease found incidentally, and was managed by laparoscopic partial nephrectomy.

Case presentation: 

A 63-year-old man was referred to our department for a renal mass which was found incidentally on  physical check-up. A 2.7cm hypovascular retroperitoneal nodule was detected at the left kidney upper pole.  Removal of the renal mass by laparoscopic partial nephrectomy was performed. The pathologic examination revealed atypical lymphoid hyperplasia with vascular proliferation of germinal center and increase of plasma cells infiltrating in parafollicular area, which compatible with Castleman’s disease.

Conclusion:

Although Castleman’s disease generalize represent as benign proliferation of lymphoid tissue, it still need to differentiate with other malignancies including mantle cell lymphoma, follicular lymphoma and renal cell carcinoma carefully. Transperitoneal laparoscopic approach is suitable and effective in the management of certain renal Castleman’s disease.