We present the case of a 30-year-old man, with no relevant medical and surgical history, who consulted for a left laterocervical tumor of several months of evolution. The patient reported night sweats as the only anamnesis in recent months.
On examination, a tumor measuring approximately 5x5cm was found in the lower third of the lower third. The auscultation revealed deep non-mustoid muscle diameter (DCM) of elastic consistency, poorly defined, non-skin-adherent
A computed tomography (CT) guided puncture was requested and reported as a cellularity of the lymph node with indeterminate changes that cannot be typified cytologically, recommending viral serological study.
Computed tomography with intravenous contrast showed a homogeneous, solid, well-defined 5x7 cm mass located in the left cervical vascular space compressing the left internal jugular vein with lymphadenopathy adjacent to the MCE.
He did not have a uptake suggestive of carotid glomus.
The radiological differential diagnosis included lymphoproliferative process, neurogenic tumor or mesenchymal tumor.
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Under general anesthesia, a horizontal left supraclavicular incision and section of the MCE muscle at this level were performed to obtain adequate exposure.
A 5x7 cm tumor of hard congestive aspect with intense peripheral vascularization that made dissection difficult was found; the tumor presented a separation plane with the vascular space.
The clinical aspect at the time of surgery impressed the authors of vascular tumor.
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The pathological study of the specimen showed that it was a lymph node with preserved architecture and marked increase in the number of lymphoid follicles and positivity for immunohistochemical markers (CD20+CD10+, b).
The germinal centers showed hyaline material, some vessels and arrangement in onion layers of the lymphocytic corona.
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The number of plasma cells (CD138) were within the normal range and showed no restriction for the light chains of immunoglobulins (kappa and lambda).
The presence of human herpes virus type 8 (HHV 8) was not detected by PCR in the molecular study.
A CT scan was performed, showing normal appearance.
Complete blood tests, immunological tests and serology were normal.
These findings represent the localized form of lymphoid angiofollicular hyperplasia or Castleman's disease, hyaline-vascular variant.
