Multidisciplinary Collaborative Treatment of Mediastinal Castleman Disease: A Case Report.

BACKGROUND Castleman disease (CD) is a rare lymphoproliferative disorder, typically classified into unicentric Castleman disease (UCD) and multicentric Castleman disease (MCD). Except for painless masses, UCD usually presents no symptoms or only compression symptoms of surrounding tissues, while MCD presents as non-specific systemic symptoms such as fever, night sweats, fatigue, anorexia, weight loss, and hepatomegaly. Consequently, the diagnosis of CD relies on excision biopsy, making its diagnosis particularly challenging. CASE REPORT A 28-year-old man presenting with cough and hemoptysis was admitted to Deqing People's Hospital. Chest computed tomography (CT) revealed a mediastinal mass below the tracheal carina, and puncture biopsy of the mass under bronchoscopy indicated lymphoid tissue hyperplasia. After multidisciplinary consultation, the possibility of malignancy in the mass was ruled out, surgical intervention was recommended, and an optimal surgical strategy was formulated. Ultimately, the patient underwent thoracoscopic-assisted mediastinal mass resection surgery and was diagnosed with UCD (hyaline-vascular variant) through postoperative histopathological examination and recovered well. CONCLUSIONS In this report, obtaining tissue samples through minimally invasive methods such as bronchoscopy facilitated the clarification of their pathological characteristics prior to surgery. Multidisciplinary team (MDT) meetings facilitated the development of optimal diagnostic and therapeutic strategies for complex diseases. For mediastinal diseases with unknown nature and non-specific clinical symptoms, performing bronchoscopic tissue biopsy and MDT before deciding whether to undergo surgery is beneficial for the patient in this report. This diagnostic and treatment process may be suitable for similar patients.