Good News in Patients Undergoing Surgery for Suspected Lung Malignancy: Unicentric Castleman Disease

Abstract

Castleman disease (CD), also known as angiofollicular lymph node hyperplasia, is a heterogeneous lymphoproliferative disorder. These lesions can be mistaken for malignancy in terms of size and imaging characteristics, necessitating their excision. In this report, we present cases of CD that mimicked lung malignancy, underscoring the need to consider CD in the differential diagnosis of patients presenting with suspected lung cancer. This study was retrospectively designed. It included six patients who underwent surgery due to suspected lung malignancy and were subsequently diagnosed with Unicentric Castleman Disease (UCD). Of the six patients, four were male and two were female, with a mean age of 36.5 years (range: 27-50 years). Half of the patients were lifelong non-smokers. Comorbid conditions were identified in three patients, while the remaining three were asymptomatic and had no comorbidities. Histopathological examination revealed hyaline vascular type in three patients, plasma cell type in one patient, and mixed type UCD in one patient. All patients are currently alive and have not required any additional treatment. UCD represents a rare lymphoproliferative disease with diverse clinical manifestations. Surgical intervention is the established gold standard for this disease, yielding more favourable survival outcomes compared to both MCD and malignant pathologies in the lung. Therefore, in cases where malignant lung disease is suspected, the potential presence of UCD should not overlooked.