Axillary Castleman disease

Abstract

The Castleman Disease (CD) is a rare benign lymphoproliferative disease. This disease typically presents with lymphadenopathy in a particular region, and its underlying causes are not completely understood. The most prevalent sites of occurrence are the mediastinum, neck, abdomen, and retroperitoneum, with only a small proportion (2%) of instances documented in the axillary area. This case report discusses a 60-year-old female patient with unicentric axillary CD in light of the current literature. During the physical examination, a mobile, painless, well-defined, and soft mass was found in the left axilla. The mass was around 8×6 cm. The patient's axillary ultrasonography revealed a 6.5 x 3 cm hypoechoic, heterogeneous solid lesion with prominent central vascularity in the left axillary tail. The patient's serological testing for HBC, HIV, and HCV were all negative. The patient was scheduled to have a diagnostic excisional biopsy. The histological study revealed the presence of hyaline vascular variant Castleman lymphadenopathy. CD is a rare benign condition characterized by abnormal growth of lymphatic tissue. It is most commonly found in the mediastinum and least commonly in the axilla. The diagnosis is established through the integration of clinical, radiographic, and pathological evidence. It is frequently discovered as an incidental finding while making a differential diagnosis of long-term lymphadenopathy. The treatment approach differs based on the specific histologic subtype, the extent of lymph node involvement, and any associated comorbidities. The hyaline vascular subtype's prognosis is more favorable than the plasma cell subtype. Surgical excision is regarded as a therapeutic intervention for individuals who have a unicentric disease and do not have additional complications. In this case report, CD was discovered incidentally during the surgical removal of axillary lymph nodes, which was done for differential diagnosis.