Angiofollicular lymph node hyperplasia of the parotid

Castleman's Disease Intra Parotid, a Case Report and Literature Review

Castleman’s disease (CD), otherwise known as angiofollicular lymph node hyperplasia, is a rare, poorly understood disorder, which often occurs in a mediastinum. Involvement of parotid gland is a considerably infrequent event. We present a 15-year-old boy patient with a swelling in the left parotid gland that has been diagnosed with CD. The clinical features, radiographic findings, and treatment plan are discussed. Furthermore, a thorough literature review demonstrated 57 published cases of CD in salivary gland with their summarized features.

Comprehensive analysis of 225 Castleman's diseases in the oral maxillofacial and neck region: a rare disease revisited

OBJECTIVES

The aim of the present study was to comprehensively summarize the epidemiological, clinicopathological characteristics, treatments as well as prognosis of Castleman's disease (CD) identified in the oral maxillofacial and neck region.

MATERIALS AND METHODS

Patients with CD in the oral maxillofacial and neck were retrieved from disease registry at our institution from Jan. 1990 to Dec. 2015. Systematic reviews from both English and Chinese literature were performed to collect the detailed information about the oral maxillofacial and neck CD. The epidemiological, clinicopathological data and treatment outcomes were further statistically analyzed.

RESULTS

Four patients with the oral maxillofacial and neck CD were identified and histologically confirmed as hyaline-vascular type. They underwent surgical excision without recurrence during the follow-up. Systematic literature reviews identified 221 cases from 123 eligible articles which satisfied the inclusion criteria. In 225 patients, most patients were diagnosed as unicentric (207) or hyaline-vascular type (205) of CD and identified in the neck, and treated by surgical resection with good prognosis. In contrast, the minority of patients was multicentric or plasma-cell/mixed type and treated by chemotherapy with inferior outcomes. Kaplan-Meir analyses revealed that both clinical and pathological types were significantly associated with patients' overall survival.

CONCLUSIONS

Although rare, most cases of the oral maxillofacial neck CD are found in adults and classified as unicentric and hyaline-vascular type of CD. Complete surgical excision is preferred with favorable prognosis for unicentric disease, whereas chemotherapy is usually exploited for multicentric disease with inferior outcomes.

CLINICAL RELEVANCE

These data provide comprehensive information about the epidemiology, clinicopathological features, treatments, and outcomes of the oral maxillofacial and neck CD.

Clinical analysis of Castleman disease (hyaline vascular type) in parotid and neck region

OBJECTIVE

The aim of this study was to analyze a single institution's experience in clinical diagnosis, treatment, and prognosis of Castleman disease (hyaline vascular type) in the parotid and neck region.

STUDY DESIGN

From 2004 to 2008, a total of 10 consecutive patients with Castleman disease (hyaline vascular type) in the parotid and neck region underwent surgery were included in this retrospective study. The preoperative examinations, clinical diagnosis, surgical treatment, and prognosis were recorded and analyzed.

RESULTS

Of the 10 patients, 4 were males and 6 female; their age ranged from 13 to 54 years with a mean of 26.6 years. The lesion occurred in the parotid region in 3 patients, in the neck region in 5 patients, and in both the parotid and neck regions in 2 patients. Their course of disease ranged from 3 months to 48 months with a mean of 12.5 months; 70% of the patients (7 out of 10) had a course of disease of <12 months. The patients always had no obvious complaint, and the laboratory examinations were almost within the normal limits. Magnetic resonance imaging/angiography were valuable on clinical diagnosis and differential diagnosis. All patients underwent surgical removal of the masses completely. During the follow-up period, which ranged from 9 months to 60 months with a mean of 38.9 months, no recurrence of the lesion occurred, and the quality of life of each patient was good.

CONCLUSIONS

Castleman disease (hyaline vascular type) in the parotid and neck region is rare, with clinical manifestation and physical examination the same as benign lesions. There is no specific indication in the laboratory tests and imaging examinations; however, magnetic resonance imaging/angiography has potential value on clinical diagnosis and differential diagnosis. Surgical resection is the choice of treatment with good prognosis.

Castleman's disease of the buccal mucosa: report of a case and review of the literature of head and neck cases

A case of Castleman's disease occurring in the buccal mucosa is described. An 84-year-old woman noticed that a mass in the left buccal mucosa that had been present for half a year. Computed tomography revealed a well-demarcated submucosal tumor, measuring 4.0 x 3.0 x 2.0 cm. The patient received no treatment at this time, and continued growth of the mass was observed. After incisional biopsy, the lesion was surgically removed. Histologically, the tumor consisted of an enlarged lymph node with conspicuous lymph follicles, in which vascular channels and deposits of eosinophilic material were noted. Laboratory examination showed an increase of serum antibody level of cytomegalovirus but of no other viruses. The patient was followed up for 1(1/2) years, with no clinical evidence of recurrence. This is the first report of Castleman's disease presenting in an oral site.

Unicentric angiofollicular hyperplasia (Castleman's disease) of the parotid: a case report

Angiofollicular lymph node hyperplasia, or Castleman's disease, is a condition of uncertain cause usually presenting with mediastinal lymphadenopathy. Occasionally other lymph node groups may be involved with or without associated systemic manifestations. A case of Castleman's disease involving parotid lymph nodes is reported in a 16-year-old female patient who presented with a painless swelling that initially was noticed at the age of 3 years. Diagnosis was established by histopathologic examination of the respected specimen. Histologic and clinical features of Castleman's disease are also discussed.

Cytodiagnosis of lesions presenting as salivary gland swellings: a report of seven cases

The cytologic and histologic findings of seven cases presenting clinically as salivary gland swellings are described. These included two cases of pilomatrixoma of skin in the parotid region, two cases of neurilemmoma in the submandibular area, a case of Kimura's disease in the peri-mandibular gland lymphoid tissue, a case of Castleman's disease in intraparotid lymph node, and a case of branchial cleft cyst in the parotid region. It is important to recognize lesions that masquerade as salivary gland tumors so that misdiagnosis and overdiagnosis on smears can be avoided and the patients can be treated appropriately.