[News] REBIO GROUP's cooperative Taikang hospital,successfully removed enlarged lymph nodes for Castleman patient

Robert Cai
Sep 2
4 min read

Recently, the General Surgery team from Nanjing University Medical School Affiliated Taikang Xianlin Drum Tower Hospital, which is REBIO GROUP's cooperative hospital, successfully performed minimally invasive surgery on a patient with a rare condition known as Castleman disease, removing an enlarged lymph node “lurking” deep in the armpit. After seeking treatment at multiple hospitals without success, the patient received precise diagnosis and treatment through the hospital’s multidisciplinary collaboration, achieving a smooth recovery post-surgery.

Young Woman’s Armpit Mass Resolved After Seeking Treatment

Mrs. Zhou, a 25-year-old nurse who is particularly attentive to her health, discovered an enlarged lymph node in her left armpit during a routine physical examination. Although the mass was painless, the findings caused anxiety for her and her family.

Zhou visited several hospitals, but due to the lymph node’s deep location near blood vessels and nerves, as well as its small size and difficulty in localization, she was advised to monitor it or pursue conservative treatment. Ultimately, Zhou sought care at Taikang Xianlin Drum Tower Hospital’s General Surgery Department, where a multidisciplinary expert consultation diagnosed her with the rare Castleman disease, followed by successful surgical removal.

Rare Disease “Lymphatic Bomb” Poses Diagnostic Challenges Near Blood Vessels and Nerves

Castleman disease (CD) is an extremely rare lymphoproliferative disorder with a global incidence of less than one in a million. Patients develop abnormally enlarged lymph nodes in areas such as the armpit, neck, or abdomen, resembling a “ticking time bomb” hidden deep within the body. While not cancerous, certain types of CD can progress to malignant tumors or trigger life-threatening systemic complications.

Zhou’s case was highly representative: her enlarged lymph node was not only deeply situated near critical blood vessels and nerves but also measured approximately 3 cm × 2 cm, making localization extremely challenging. Additionally, the disease’s clinical presentation mimics common lymph node enlargement, making it prone to misdiagnosis.

Minimally Invasive Techniques and Multidisciplinary Collaboration Overcome “Surgical No-Go Zone” Challenges

Facing this complex case, the General Surgery team at Taikang Xianlin Drum Tower Hospital collaborated with experts from the Ultrasound and Pathology Departments to tackle the challenge.

During the surgery, the team utilized ultrasound for precise localization, employing minimally invasive techniques with real-time ultrasound guidance to accurately insert a localization needle into the lesion, successfully avoiding blood vessels and nerves while completely removing the lymph node. The procedure was minimally invasive, and the patient was discharged after only two days of hospitalization. Pathology confirmed unicentric Castleman disease, and the patient recovered well post-surgery.

“This type of surgery is like defusing a bomb in a minefield—removing the lesion entirely while ensuring zero damage to surrounding blood vessels and nerves,” said Professor Guan Wenxian, Director of General Surgery. The ultrasound localization technology used by the team controlled surgical precision to the millimeter level, while multidisciplinary consultation provided a “one-stop” solution, sparing the patient the burden of repeated referrals.

Early Diagnosis and Precision Treatment for Rare Diseases: Don’t Ignore Abnormal Physical Exam Findings

Professor Guan Wenxian emphasized that Castleman disease often presents with subtle early symptoms, with most patients seeking care due to painless masses.

If a physical exam reveals enlarged lymph nodes in areas like the armpit or neck—especially significant enlargement in a single site—rare diseases should be considered. Currently, unicentric CD can be cured through surgical resection with precise localization and minimally invasive techniques. Patients should not be overly concerned, as early diagnosis and treatment are key.

Department and Expert Introduction

The General Surgery Department of Taikang Xianlin Gulou Hospital affiliated to Nanjing University Medical School is a specialty integrating clinical, teaching and scientific research. Under the transformation of the discipline leader Professor Guan Wenxian, the department is now divided into three diagnosis and treatment groups: hepatobiliary gastrointestinal surgery, prostate and breast surgery, and anorectal surgery. The department has 52 beds and 20 physicians, including 10 with senior professional titles, 1 with masters and 9 with doctorates. The department is equipped with advanced 3D laparoscopes, choledochoscopes, ultrasonic scalpels, recurrent laryngeal nerve detection systems, breast minimally invasive systems and other medical equipment. We are dedicated to providing patients with high-quality general surgery treatment services in the fields of liver, gallbladder, benign gastrointestinal diseases, extra-abdominal hernias (abdominal wall hernias, pits, inguinal, femoral hernias, etc.), and intra-abdominal hernias (esophageal hiatus, hernias, etc.).

Department Head

Title: Chief Physician, Doctoral Supervisor, Second-Level Professor, Administrative Director of General Surgery at Taikang Xianlin Drum Tower Hospital
Specialties: Surgical treatment of gastrointestinal, hepatobiliary, pancreatic, thyroid, and breast diseases, with expertise in complex cases such as gastric cancer, ultra-low rectal cancer, pancreatic cancer, liver cancer, large abdominal tumors, and retroperitoneal tumors. Performs over 1,000 complex level-4 surgeries annually, including radical gastrectomy, sphincter-preserving low rectal cancer surgery, retroperitoneal tumor resection, pancreaticoduodenectomy, and radical resection for liver and gallbladder cancers.
Professional Roles: Chairman of the Jiangsu Medical Association Oncology Branch, Vice Chairman of the Jiangsu Medical Association Surgery Branch, President of the Jiangsu Physicians Association Surgical Branch, Head of the Jiangsu Medical Association Gastrointestinal Surgery Group, Deputy Director of the Jiangsu General Surgery Quality Control Center, Standing Council Member of the Jiangsu Anti-Cancer Association, Vice Chairman of the Gastrointestinal Stromal Tumor Committee, and Director of the Nanjing General Surgery Quality Control Center.
Research Achievements: Published over 230 papers, including 110+ SCI-indexed articles, authored 4 monographs, co-edited 10 monographs, received three third-class merits, and won a National Science and Technology Progress Second Prize and an All-Army Medical Achievement First Prize as the second author.

At REBIO GROUP, we are proud to collaborate with Nanjing University Medical School Affiliated Taikang Xianlin Drum Tower Hospital as a trusted partner in cross-border healthcare. Our mission is to connect international patients with world-class medical care in China. If you or a loved one are seeking advanced treatment, such as the cutting-edge minimally invasive procedures showcased in this case, our dedicated team can facilitate your journey to receive top-tier healthcare services in China. Contact us today to learn how we can support your path to recovery with seamless, high-quality medical solutions.