Castleman lymphoma originated from the posterior mediastinum resected thoracoscopically: report of a case

• Published in: Kyobu geka. The Japanese journal of thoracic surgery Vol. 55; no. 6; p. 519
• Main Authors: Fukino, S, Fukata, T, Hayashi, E, Okada, K, Metsugi, H, Suda, T, Morio, S
• Format: Journal Article
• Language: Japanese
• Published: Japan 01-06-2002
• Subjects: Adult; Castleman Disease - pathology; Castleman Disease - surgery; Female; Humans; Mediastinum - pathology; Thoracic Surgery, Video-Assisted; Thoracoscopy; Thoracotomy - methods
• ISSN: 0021-5252

We report thoracoscopic resection of Castleman lymphoma originated from the posterior mediastinum. The patient was a 19-year-old woman, who was pointed out to show an abnormal shadow in the left upper lung in the chest X-ray photograph. It was diagnosed as a blood-rich posterior mediastinal tumor by dynamic MRI, and thoracoscopic surgery was performed. The tumor was adjacent to the vertebral body of the fourth thoracic vertebra. Although operation involved 2 hours and 40 minutes and 670 ml of bleeding due to a strong adhesion between the tumor and the intercostal muscle and considerable bleeding from the tumor itself, it was successfully removed under thoracoscopy. The tumor was elastic and hard, and 50 x 45 x 25 mm in size. The histopathological diagnosis was a Castleman lymphoma, hyaline vascular type. The postoperative course was satisfactory, and the patient was discharged from the hospital on the 7th postoperative day. Castleman lymphoma originated from the posterior mediastinum tends to bleed considerably during its resection. If a blood-rich posterior mediastinal tumor was found preoperatively, thoracoscopic operation must be advanced carefully keeping this disease in mind.