BACKGROUND:

Castleman's disease, or angiofollicular lymph node hyperplasia, is a diagnostic and therapeutic challenge for most physicians. It may be associated with viral infections, such as herpes virus type 8, or be idiopathic. In turn, it can be localized in a single region (unicentric) or affect several (multicentric). It is usually diagnosed in the fourth decade of life and is a finding when it is the unicentric variant.

CLINICAL CASE:

19 year old patient who came to consult due to the appearance of a nodule in the right breast. Breast and axillary ultrasound showed bilateral fibroadenomas and adenomegaly on the left side, with high vascularity. It was classified as BIRADS 3. The histopathological report of the biopsy, with cutting needle, of the left axillary node was: atypical lymphoid proliferation. Immunohistochemistry reported positivity for: CD20, CD3, CD21 on interfollicular dendritic cells, Ki-67 and negativity for HHV-8 in residual germinal centers.

CONCLUSION:

Surgical removal of a unicentric hyaline-vascular-plasmic type mass is curative. Evaluation of patients with suspected disease should include, in addition to pathologic evaluation with immunostaining, laboratory and systemic imaging studies with PET-CT to determine the extent of disease (unicentric or multicentric) and for follow-up markers.

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