Giant lymph node hyperplasia a diagnostic dilemma in the neck

Giant lymph node hyperplasia (GLNH) or Castleman's disease is a rare pathol ogical entity commonly presenting as a solitary mediastinal tumour (unifoca l variant). although other anatomical sites have been reported including th e head and neck, abdomen and axilla. Though the head and neck is the second commonest site for this lesion, only 60 cases [1.2] have been reported in the literature. Pre-operative diagnosis of the unifocal variant can be diff icult as routine investigations carried out in the clinic setting are often inconclusive. A multicentric ti,rm of this disease with a poorer prognosis in comparison to the unifocal lesion has been described by Gaba et al. in 1978 [3]. We present a case of an unusually large, slow growing, asymptomat ic, unifocal variant of this tumour restricted to the neck which underwent successful surgical excision. A review of the literature, histopathological characteristics and differential diagnosis is also presented. (C) 2001 Els evier Science Ireland Ltd. All rights reserved.