Castleman's disease in the head of the pancreas: report of a rare clinical entity and current perspective on diagnosis, treatment, and outcome.
BACKGROUND
Castleman's disease of the pancreas is a very rare condition that may resemble more common disease entities as well as pancreatic cancer.


METHODS
Here we report the case of a 58-year-old African American male with an incidentally discovered lesion in the head of the pancreas. The specimen from his pancreaticoduodectomy contained a protuberant, encapsulated mass, exhibiting microscopic features most consistent with localized/unicentric Castleman's disease. These included florid follicular hyperplasia with mantle/marginal zone hyperplasia along with focal progressive transformation of germinal centers admixed with involuted germinal centers.


CONCLUSIONS
To date, eight cases of Castleman's disease associated with the pancreas have been described in the world literature. We report the first case of unicentric disease situated within the head of the pancreas. In addition, we discuss the diagnostic dilemma Castleman's disease may present to the pancreatic surgeon and review current data on pathogenesis, treatment, and outcome.
Wang
Hongbei
H
Department of Pathology, The State University of New York, Health Science Center of Brooklyn, NY, USA. Hongbei.Wang@downstate.edu
Wieczorek
Rosemary L
RL
Zenilman
Michael E
ME
Desoto-Lapaix
Fidelina
F
Ghosh
Bimal C
BC
Bowne
Wilbur B
WB
D000230:Adenocarcinoma / Q000473:pathology; D005871:Castleman Disease / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000473:pathology; D016577:Pancreaticoduodenectomy; D014057:Tomography, X-Ray Computed