Abstract
A 61-year-old Turkish woman presented with a 10-month history of chest pain. Chest radiography showed nonhomogeneous density obliterating left costophrenic sinus. Chest computed tomography revealed a heterogeneous mass measuring 40×60-mm with calcification and necrosis at left posterolateral hemithorax. Bronchoscopy was normal. CT-guided cutting needle biopsy was nondiagnostic. Magnetic resonance imaging revealed 40×60-mm sized mass having central calcification and necrosis at left posterolateral hemithorax. On thoracotomy, an extraparenchymal mass destructing the ribs was determined. Mass excision and partial chest wall resection were performed. Grossly, the mass was pinkish yellow in colour and had a rubbery consistency with fibrous bands. Microscopic examination was characterized by germinal follicules surrounded by concentric layers of small lymphocytes and proliferative hyalinized vascular stroma in parafollicular area. All tumor cells stain positively with CD45, and negatively with pancytokeratin, while the follicular cells stain positively with CD20, and the parafollicular cells stain positively with CD3, immunohistochemically. The final diagnosis was angiofollicular lymph node hyperplasia (Castleman's disease) hyaline- vascular type in pleura.
- © 2011 ERS
