Castleman disease: CT and MR imaging features of a retroperitoneal location in association with paraneoplastic pemphigus

Abstract

We describe the CT and MRI features of a case of Castleman disease which was unusual by both its retroperitoneal location and its association with paraneoplastic pemphigus.

Retroperitoneal Castleman's tumor and paraneoplastic pemphigus: report of a case and review of the literature

“…Castleman's disease is a rare lymphoproliferative syndrome which was first described in 1956 [1]. The etiology and pathogenesis of this entity is still unclear.…”

Pancreatic Castleman's disease: MR findings

“…A small hepatic cyst is seen also (a-d, arrowheads) L50 for pancreatic carcinoma [2,8]. Percutaneous fine-needle aspiration biopsy is often not diagnostic in Castleman's disease [10]. The MRI-based differential diagnosis of CD must address a number of disorders, including ductal adenocarcinoma, and two rare nodular forms of primary pancreatic lymphoma [11] and pancreatic tuberculosis [12].…”

“…In previous reports, most localized forms of CD appear as a well-marginated mass, hypointense to the liver on T1-weighted images and hyperintense on T2-weighted images, with variable but moderate or pronounced enhancement after administration of gadolinium chelate contrast [4,5,10]. Isolated cases of localized hyaline vascular forms have been reported to have central and linear hypointense areas on both T1-and T2-weighted images, attributed to calcifications, fibrous septa, or vessels [4,9,10]. The MR signal intensity on T2-weighted images and the MR enhancement characteristics of the pancreatic mass seen in our patient differed from those reported for other CD lesions found elsewhere in the body [4,5,10].…”

“…Isolated cases of localized hyaline vascular forms have been reported to have central and linear hypointense areas on both T1-and T2-weighted images, attributed to calcifications, fibrous septa, or vessels [4,9,10]. The MR signal intensity on T2-weighted images and the MR enhancement characteristics of the pancreatic mass seen in our patient differed from those reported for other CD lesions found elsewhere in the body [4,5,10]. We believe that the principal reason may be the difference in the histologic type of the disease.…”

Gray-scale and color Doppler sonographic findings in a case of mesenteric Castleman's disease incidentally detected in a patient with Graves' disease

“…2 The histological diagnosis is based on the cellular architecture of the entire surgical specimen, because percutaneous biopsies may be misleading. 4,5 Castleman's disease appears mainly as an isolated mass and is curable by surgery. Occasionally, the disease presents as a multicentric lymphoproliferative disorder with systemic manifestations and with an aggressive, often fatal, clinical course.…”