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.