A case of Castleman's disease accompanied with lung cancer

Abstract

A 69-year-old man presented with dyspnea. Chest CT showed a 1.5cm nodule in the right upper lobe and a 6cm subcarinal mass. PET scan showed FDG uptake in both lesions, indicating primary lung cancer with mediastinal lymph node metastasis. After the biopsy of the subcarinal mass through mediastinoscope and thoracoscope resulted no evidence of malignancy, the patient underwent a right upper lobectomy with mediastinal lymph node dissection including the excision of the subcarinal mass. Pathological examination revealed the right upper lobe nodule as adenocarcinoma with hilar nodes metastasis (pT2N1M0) and the subcarinal mass as Castleman's disease. It was difficult to distinguish Castleman's disease from mediatinal lymph node metastasis of lung cancer with PET scan. Attention should be paid in staging of lung cancer when such a lymph node disease is combined.