Thoracic Paraspinal Castleman Disease in a Young Mexican-American Man with Postcoital Hematuria

World Neurosurgery
Chase H FosterNiti Manglik

Abstract

Castleman disease (CD) is an uncommon disorder of deregulated lymphoproliferation with unicentric (UCD) and multicentric forms based on extent of nodal involvement. Gross resection with histopathologic analysis remains the gold standard for diagnosis of UCD and is curative in most cases. Symptomatic paraspinal UCD is a rare presentation with potentially dangerous complications, and its tendency to mimic more common spinal tumors presents a significant diagnostic challenge. A 25-year-old Hispanic man with no past medical history was evaluated for a known left-sided paraspinal mass that was incidentally discovered during an emergency department work-up for hematuria. Computed tomography on initial presentation revealed a 5.3 cm × 3.3 cm × 4.8 cm heterogeneously enhancing left paraspinal mass adjacent to the T11 vertebral body with tonguelike extension into the T11-T12 neural foramen. Although he remained neurologically intact throughout most of the diagnostic work-up, an inconclusive biopsy, worsening hematuria, and late-onset radiculopathy with severe back pain prompted surgical intervention. Microscopic histomorphology was consistent with CD. He continued to have intermittent hematuria and dysuria postoperatively, but repeat co...Continue Reading

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Castleman Disease

Castleman disease is a rare disorder that involves an overgrowth of cells in the lymph nodes. Unicentric Castleman disease affects one lymph node, usually in the chest or abdomen. Multicentric Castleman disease affects multiple lymph nodes, commonly located in the neck, collarbone, underarm and groin areas. Discover the latest research on Castleman disease here.

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