Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2017; 9(9): 397-401
Published online Sep 15, 2017. doi: 10.4251/wjgo.v9.i9.397
Cervical Castleman’s disease mimicking lymph node metastasis of esophageal carcinoma
Takumi Yamabuki, Masanori Ohara, Mototsugu Kato, Noriko Kimura, Tomohide Shirosaki, Kunishige Okamura, Aki Fujiwara, Ryo Takahashi, Kazuteru Komuro, Nozomu Iwashiro, Satoshi Hirano
Takumi Yamabuki, Masanori Ohara, Tomohide Shirosaki, Kunishige Okamura, Aki Fujiwara, Ryo Takahashi, Kazuteru Komuro, Nozomu Iwashiro, Department of Surgery, National Hospital Organization Hakodate Hospital, Hakodate 041-8512, Japan
Mototsugu Kato, Department of Gastroenterology, National Hospital Organization Hakodate Hospital, Hakodate 041-8512, Japan
Noriko Kimura, Department of Pathology, National Hospital Organization Hakodate Hospital, Hakodate 041-8512, Japan
Satoshi Hirano, Department of Gastroenterological Surgery II, Hokkaido University Hospital, Sapporo 060-8648, Japan
Author contributions: Yamabuki T wrote the manuscript; Kimura N was in charge of the pathological diagnosis; Ohara M, Shirosaki T, Okamura K, Fujiwara A, Takahashi R, Komuro K and Iwashiro N participated in the medical care of the patient; Kato M and Hirano S served as the scientific advisor.
Institutional review board statement: This case report was approved by the ethics committee of National Hospital Organization Hakodate Hospital.
Informed consent statement: All study participants provided informed written consent prior to the treatment.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Takumi Yamabuki, MD, PhD, Department of Surgery, National Hospital Organization Hakodate Hospital, 18-16 Kawahara-cho, Hakodate 041-8512, Japan. bukiyama@themis.ocn.ne.jp
Telephone: +81-138-516281 Fax: +81-138-516288
Received: January 28, 2017
Peer-review started: February 9, 2017
First decision: March 22, 2017
Revised: April 6, 2017
Accepted: May 18, 2017
Article in press: May 19, 2017
Published online: September 15, 2017
Processing time: 225 Days and 13.4 Hours
Abstract

Castleman’s disease (CD) is an uncommon benign lymphoproliferative disorder of unknown etiology. A rare case of cervical CD diagnosed at lymph node dissection for esophageal carcinoma is reported. An esophageal tumor was identified in a 67-year-old man during a follow-up examination after surgery for oral carcinoma. Esophagoscopy revealed a type 1 tumor in the cervical esophagus. Histology of esophagoscopic biopsies indicated squamous cell carcinoma. Contrast-enhanced computed tomography revealed swollen lymph nodes of the right cervical region. No distant metastasis was detected. Esophageal carcinoma, T2N2M0, Stage IIIA was diagnosed. Neoadjuvant chemotherapy was recommended, but the patient rejected the chemotherapy. The patient underwent laparoscopic-assisted transhiatal esophagectomy. The histopathological diagnosis was moderately differentiated squamous cell carcinoma with pT1bN0M0, Stage IA. On histology, the swollen lymph nodes of the right cervical region revealed CD. The patient’s postoperative course was relatively good.

Keywords: Castleman’s disease; Lymph node metastasis; Esophageal carcinoma

Core tip: The association of Castleman’s disease (CD) with epithelial malignancy is rare. To the best of our knowledge, the present case is the first report of a synchronous esophageal carcinoma and cervical CD. In the present case, we clinically diagnosed esophageal carcinoma with right cervical lymph nodes metastasis, T2N2M0, Stage IIIA preoperatively, but the stage was revised to pT1bN0M0, Stage IA on pathological diagnosis. Via histology, the swollen lymph nodes of the right cervical region revealed CD. This case demonstrates that cervical CD is rarely associated with an esophageal carcinoma and can clinically mimic nodal metastasis.