Author(s): Pawan Kumar Rathod1, Lokesh Reddy Chigicherla2, Venkat Ram Reddy Kuchukulla3, (Brig) Satyanarayana Moorthy R4, Ramakrishna Reddy Gaddam5

A 55-year-old female patient presented in the month of September 2016 with a painless mass in left submandibular region, which appeared two years ago and progressively increased in size. There were no constitutional symptoms such as fever, night sweating, fatigue and weight loss. On USG, single well-defined oval-shaped homogeneously hypoechoic mass lesion noted in left submandibular region measuring 6.2 x 3.8 cm. On colour Doppler examination showed peripheral parenchymal vascular flow and increased diastolic flow within center of the lesion. Plain and contrast CT examination was done showed single well-defined hypodense oval-shaped mass lesion in left submandibular region displacing vascular structures medially and posteriorly on post-contrast images showed intense enhancement of mass lesion. Biopsy from the lesion revealed structure of lymph node with partial effacement of lymph nodal architecture. Few lymphoid follicles were seen at periphery. The distorted lymph node showed hyalinised blood vessels in centre of follicle surrounded by mantle of mature lymphocytes. Features suggestive of hyaline vascular variant of angiofollicular lymph node hyperplasia also known as Castleman disease.

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