Cytological diagnosis of Castleman's disease of the soft tissue
A 55-year-old woman with no history of major illness presented with a 2-year history of a painless, elastic soft mass in the right arm gradually increasing in size, measuring 5 cm × 4.5 cm × 2.5 cm. She had no other symptoms. Routine laboratory investigations showed no abnormality. There were no systemic symptoms, draining axillary lymph nodes were not enlarged and no other organomegaly. Radiograph of the arm showed mild periosteal reaction of underlying bone. Ultrasonography findings suggested that the lesion was a primary hypervascular soft-tissue tumor.\nSmears were highly cellular and showed polymorphous cell population with predominance of small lymphocytes and few tingible-body macrophages []. Few singly scattered large oval cells with indistinct margins were seen. These cells had pale cytoplasm with fine chromatin with inconspicuous nucleoli. There was prominent vascularity with capillaries. There were no epithelioid cells, giant cells or necrosis. However, few immunoblasts were seen. Plasma cells were few in number. The cytological picture was that of reactive hyperplasia with additional findings of capillaries amongst germinal center cells. A diagnosis of reactive hyperplasia with a strong indication of CD was made [].\nGrossly, the excised tumor was grey tan with a homogenous cut surface. Microscopically, the sections showed diffuse lymphoid cell population chiefly of small to medium cells along with many small blood vessels. These findings confirmed CD, hyaline vascular type.