Castleman's disease — The lymphoma impostor

The asymptomatic neck mass in the middle‐aged adult is not an uncommon clinical dilemma for the otolaryngologist‐head and neck surgeon. After a complete medical evaluation and panendoscopy with multiple “blind” biopsies, the patient usually comes to excisional biopsy, when the prior work‐up has not added any positive information. Most commonly, in this age group, the mass represents metastatic cancer from a head and neck primary, a carcinoma from a distant site, or a lymphoma. We present a case of Castleman's disease, a benign lymphoepithelial disease that can easily be mistaken for lymphoma.