Rare disease: Sorry... It was not a sore throat!! Castlemans disease in a 19-year-old previously normal young patient

摘要

A 19-year-old male patient presented to the emergency department with a small amount of haemoptysis preceded by coughing and sneezing. He came back from Portugal a week ago. His physical examination was unremarkable and his routine blood tests were normal apart from a slightly raised D dimer. His chest x-ray revealed a mediastinal mass, which appeared on CT as a right-sided mediastinal mass with low attenuation compressing the superior vena cava. The CT angiogram showed multiple arterial supply from the brachiocephalic, vertebral and bronchial arteries; they drained into internal jugular, subclavian and azygous system. CT-guided biopsy was performed followed by operative excision of the mass 5 weeks later. Both histology results confirmed a hyaline vascular variant of Castleman's disease with no evidence of any malignancy.