Castleman’s disease (CD) arising from the hepatoduodenal ligament is extremely rare. A 32-year-old man was referred to a clinic with nausea. He was found to have an abdominal mass by ultrasonography and consulted our hospital for further examination. Computed tomography revealed an equally enhancing mass, 5.2 cm in diameter, adjacent to the duodenum. On magnetic resonance imaging, the mass revealed a slightly iso-intensity signal equal to smooth muscle on T1-weighted imaging, a slightly high-intensity signal on T2-weighted imaging, and a high-intensity signal on diffusion-weighted imaging. Endoscopic ultrasonography showed a well-demarcated hypoechoic mass adjacent to the duodenum. The Doppler echo pattern indicated abundant blood flow. The preoperative diagnosis was a duodenal gastrointestinal stromal tumor. The patient underwent laparotomy and tumor excision. The finding of the intraoperative frozen section was CD. Histologically, the lymph follicles were markedly increased in number throughout the cortex and medulla with vascular proliferation and hyalinization in the intra- or extra-follicles. The germinal centers were atrophic and surrounded by concentrically arranged layers of small lymphocytes. The histological findings were the hyaline vascular variant of CD. If a hypervascular solid mass is detected in the abdomen, CD should be considered in the differential diagnosis.
Case Rep Gastroenterol 2021;15:424–430

中文翻译：

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模仿十二指肠胃肠道间质瘤的肝十二指肠韧带引起的卡斯曼病

由肝十二指肠韧带引起的Castleman病（CD）非常罕见。一名32岁的男子因恶心被转诊至诊所。通过超声检查发现他的腹部有肿块，并咨询了我们的医院进行进一步检查。计算机断层扫描显示与十二指肠相邻的直径为5.2 cm的肿块同样增大。在磁共振成像中，肿块在T1加权成像中显示出与平滑肌相等的稍微等强度的信号，在T2加权成像中显示出稍高强度的信号，在扩散加权成像中显示出高强度的信号。内镜超声检查显示十二指肠附近有界限清楚的低回声肿块。多普勒回声模式表明血流量丰富。术前诊断为十二指肠胃肠道间质瘤。该患者接受了剖腹手术和肿瘤切除术。术中冰冻切片发现为CD。从组织学的角度来看，整个皮层和髓质中的淋巴滤泡数量明显增加，并且滤泡内或滤泡外的血管增生和透明化。生发中心萎缩，并被同心排列的小淋巴细胞层包围。组织学结果是CD的透明血管变体。如果在腹部检测到高血管实性肿块，则在鉴别诊断中应考虑CD。生发中心萎缩，并被同心排列的小淋巴细胞层包围。组织学结果是CD的透明血管变体。如果在腹部检测到高血管实性肿块，则在鉴别诊断中应考虑CD。生发中心萎缩，并被同心排列的小淋巴细胞层包围。组织学结果是CD的透明血管变体。如果在腹部检测到高血管实性肿块，则在鉴别诊断中应考虑CD。
病例代表胃肠道2021; 15：424–430