Castleman Disease (CD) is a rare non-clonal lymphoproliferative disorder. The clinical presentation of CD often overlaps with autoimmune, infectious, or other malignant diseases. The diagnosis is confirmed by a biopsy of the affected lymph-node tissue. A 39-year-old gentleman was evaluated for intractable abdominal pain fatigue of 2 months duration. CT scan showed a 4 X 4 X 5 cm right suprarenal mass. Laparotomy and near total excision was performed which showed reactive B cells expressing CD20 and PAX5, favoring CD. Patient received adjuvant 6 cycles of Rituximab and steroids. A follow up CT scan after 3 months showed a near complete resolution.
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