Small bowel obstruction caused by a large B-cell lymphoma in a patient with multicentric Castleman's disease: An unusual occurrence

Int J Surg Pathol. 2014 Aug;22(5):434-7. doi: 10.1177/1066896913507599. Epub 2013 Oct 31.

Abstract

Multicentric Castleman's disease is a rare condition of systemic nonclonal lymph node hyperplasia. Because of its strong association with human herpes virus 8 (HHV8), the multicentric, more aggressive, form may progress to Kaposi sarcoma or non-Hodgkin lymphoma. While surgery is curative in the treatment of localized Castleman's disease, operative treatment of the diffuse form has as yet been unsatisfactory. We report the case of a patient presenting with postprandial vomiting of 1 month duration consistent with partial small bowel obstruction secondary to terminal ileum intussusception. Resection of the small bowel showed a stenosing tumor triggering the intussusception. On pathological examination, the tumor was found to be composed of HHV8-positive plasmablastic lymphoma cells. To our knowledge, this represents the first case of a complication due to the progression of multicentric Castleman's disease requiring surgical intervention for intussusception.

Keywords: human herpes virus 8; intussusception; large B-cell lymphoma; multicentric Castleman’s disease; small bowel obstruction.

Publication types

  • Case Reports

MeSH terms

  • Castleman Disease / complications*
  • Castleman Disease / pathology
  • Humans
  • Intestinal Obstruction / etiology*
  • Intestinal Obstruction / pathology
  • Lymphoma, Large B-Cell, Diffuse / complications*
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Male
  • Middle Aged

Supplementary concepts

  • Multi-centric Castleman's Disease