Cytomorphology of Castleman’s Disease of Parotid Gland: Pitfalls and Diagnostic Dilemma in a Young Adult

Abstract

Fine needle aspiration cytology (FNAC) is an easy, effective diagnostic tool that makes it the procedure of choice for all accessible swellings in the body. Castleman’s disease (CD) may present as unicentric or multicentric swelling hence is subjected to FNAC very frequently. CD mainly presents mediastinal nodes, nonetheless when present in salivary glands such as parotid, it is often diagnosed clinically as a salivary gland tumor. However, due to lack of adequate literature on its cytological features and non- specific radiological findings, the condition is often misdiagnosed. There are few case series on cytological features of CD and even fewer cases of CD in the parotid gland. Histopathology serves as the gold standard of diagnosis for CD. In superficial locations, these swellings are easily subjected to direct fine needle aspiration cytology (FNAC). Radiologically guided FNA can be performed for deeper locations. Hence, the authors present a case of 19 year old male patient, who presented with a small superficial, preauricular swelling for FNAC. The initial FNAC yielded no conclusive opinion. however a repeat FNAC and histopathological examination led to the final diagnosis. This case report aims to highlight the cytomorphological and histopathological features of CD in the Parotid gland and various difficulties encountered in making the final diagnosis.