Chest wall Castleman's disease: CT and MRI findings

Tanaka, Osamu; Kiryu, Takuji; Hirose, Yoshinobu; Fujikake, Rizu; Sakurai, Ken-ichi; Hoshi, Hiroaki

doi:10.1007/s11604-006-0063-9

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…In previously reported cases, thoracoliths ranged in size from 5 to 15 mm (mean size, 8 mm)[ 3 ], and in most cases, presented as multiple small ovoid nodules located in the left pleura[ 3 , 4 , 11 , 20 ]. In our case, the thoracolith measured approximately 9 cm in length.…”

Section: Discussionmentioning

confidence: 99%

Formation of a rare curve-shaped thoracolith documented on serial chest computed tomography images: A case report

Hsu¹,

Huang²,

Pu³

2023

World J Clin Cases

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BACKGROUND Thoracolithiasis is a rare benign condition that manifests with one or more small nodules in the pleural cavity. In most cases, it is asymptomatic and found incidentally on chest imaging or during thoracic surgery. The thoracolithiasis formation process is rarely documented. Herein, we present a case of a rare, large, curve-shaped thoracolith, the formation of which was documented on serial computed tomography (CT) images. CASE SUMMARY A 46-year-old male patient who denied any prior systemic disease was evaluated due to intermittent right-sided lateral chest pain lasting for a year. Chest radiography and CT revealed a circumscribed calcified nodule measuring 3.5 mm in the right lower lung lobe. Nodule biopsy revealed fungal infection, which was treated with antifungal medication. After 2 years of follow-up, the patient developed intermittent chest discomfort caused by pleural adhesions, and underwent video-assisted thoracic surgery with pneumolysis. Postoperatively, he developed empyema, which fully resolved with antibiotic therapy. Thereafter, he was followed up at the outpatient clinic and underwent chest CT twice per year. Over time, we observed thickening of the right distal pleura near the lower posterior mediastinum, and several sporadic calcified nodules with gradually increasing intensity, which eventually merged into a single calcified curve-shaped thoracolith measuring approximately 9 cm in length during the 5-year follow-up. CONCLUSION This study documented the formation of a rare thoracolith shape observed for the first time.

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Section: Discussionmentioning

confidence: 99%

Formation of a rare curve-shaped thoracolith documented on serial chest computed tomography images: A case report

Hsu¹,

Huang²,

Pu³

2023

World J Clin Cases

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“…Various theories have been proposed regarding the origin of these thoracoliths, including degenerated pleural lipomas [3] (a rare entity themselves); past history of tuberculosis; phagocytosis of dust particles by macrophages [4]; or migration of pleural or pericardial fat into the pleural space [5]. However, none of these theories have been validated.…”

Section: Discussionmentioning

confidence: 99%

Thoracoliths in Pleural Space Mimicking Lung Cancer: A Case Report

Aftab,

Fredenburg,

Rackauskas

et al. 2023

Cureus

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Pulmonary nodules often present a diagnostic challenge due to their diverse etiology, ranging from benign to malignant conditions. We discuss the diagnostic journey of a 71-year-old female patient with a history of kidney stones, who was incidentally found to have a pleural-based pulmonary nodule during a CT urogram. Subsequent imaging showed nodule growth, prompting further investigations, including a PET/CT scan and CT-guided biopsy, which yielded inconclusive results. A multidisciplinary approach recommended surgical resection, revealing three mobile calcified-like nodules within the pleural space, later identified as hyalinized nodules. The absence of malignancy was reassuring.These benign, mobile pleural bodies, known as thoracoliths, are challenging to differentiate from pulmonary nodules. This case underscores the importance of considering rare benign entities in pulmonary nodule differentials and highlights the need for a multidisciplinary approach, surgical intervention, and openmindedness in complex diagnostic scenarios.

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“…A plasmablastic subtype is observed in HHV-8-positive patients. CD can occur in practically any part of the body, but arises predominantly in the thorax (~70%), followed by the abdomen and pelvis (~15%) and neck (~15%) (2,4,5). Despite numerous case presentations since Castleman et al first report in 1954, CD remains a diagnostic and therapeutic challenge (6).…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological comparison and therapeutic approach to Castleman disease—a case-based review

Wojtyś¹,

Piekarska²,

Kunc

et al. 2019

J Thorac Dis

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Castleman disease (CD) is a rare, B-cell lymphoproliferative disorder affecting lymph nodes and extranodal anatomical locations. Four types of clinical presentations can be distinguished after exclusion of mimics. The first division is into unicentric CD (UCD) and multicentric CD (MCD). MCD is classified further as HHV-8-negative (idiopathic), MCD associated with HHV-8 infection, and POEMS associated MCD. From the histological standpoint, UCD and MCD can be classified as hyaline-vascular (HV), plasma cell (PC), or mixed cellularity (MC) type, with a spectrum of histopathological manifestations. We present clinical and histopathological features and grading of 25 cases of CD classified according to CDCN histological criteria and according to this clinical algorithm, along with outcomes. Here we provide a fineresolution description of the histological features of CD. We review and discuss the current diagnostic algorithm, grading system, and recently recommended treatment options. In the presented group of 25 patients with CD there were 14 women and 11 men in the age range 15-79 years. UCD was identified in 15 patients and it was most often located in mediastinum. MCD most frequently occurred as generalized lymphadenopathy. The most common type of CD was HV. All patients with UCD underwent complete surgical resection with a positive outcome. Patients with MCD had diagnostic partial surgical excision of the lesions, later followed by different types of treatment (corticosteroids, chemotherapy, radiotherapy, immunomodulatory agents) or 'watch and wait'. In four cases CD was associated with other malignancies (laryngeal cancer, small lymphocytic lymphoma, gallbladder cancer with hepatic metastases, primary squamous cell lung cancer). The accuracy of histopathological examination is essential and re-evaluation has to be performed in case of relapse or unexpected course of CD. Treatment tailored to fit the disease type and severity should follow the novel recommendations, including anti-IL-6 treatment in the case of MCD.

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Chest wall Castleman's disease: CT and MRI findings

Cited by 5 publications

References 20 publications

Formation of a rare curve-shaped thoracolith documented on serial chest computed tomography images: A case report

Formation of a rare curve-shaped thoracolith documented on serial chest computed tomography images: A case report

Thoracoliths in Pleural Space Mimicking Lung Cancer: A Case Report

Clinicopathological comparison and therapeutic approach to Castleman disease—a case-based review

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