Castleman disease in the hilum liver mimicking the lymph node metastasis of hepatocellular carcinoma on 18F-FDG PET/CT

RATIONALE: Castleman disease is a rare lymphoproliferative disorder which etiology is unknown. It is divided into 2 subtypes: the plasma cell variant and the hyaline vascular variant. The most common site is the hilum of the lungs and mediastinum. Castleman disease is often ignored by clinicians because of not frequently encountering in clinical and the lower uptake of F-FDG. Here, we report a case of hepatocellular carcinoma accompanied by Castleman disease in the hilum of the liver, which was misdiagnosed as the lymph node metastasis in F-FDG PET/CT imaging. PATIENT CONCERNS: A 63-year-old male with chief complaint of acratia and poor appetite for 2 weeks. DIAGNOSES: Hepatocellular carcinoma accompanied by Castleman disease in the hilum of liver. INTERVENTIONS: Right hemihepatectomy and hilar lymph node dissection was performed and preventative transcatheter arterial chemoembolization therapy was given after the surgery. OUTCOMES: The case had multiple systemic metastasis due to tumor progression. LESSONS: Castleman disease is a benign and rare lympholiferative disease, and easy to be ignored in clinical. The case of hepatic carcinoma with Castleman disease in the hilum of liver has never been reported before. Here, we report it and hope it provides a differential diagnosis for clinicians in the following similar cases.