Imaging and clinical features of Castleman Disease

Abstract

Background Castleman disease (CD) is a group of uncommon lymphoproliferative disorders that is easily confused with lymphoma or other solid tumors. The purpose of our study was to evaluate the imaging and clinical findings of CD, and thus improve the understanding and diagnosis of CD. Methods This retrospective study included 74 patients (37 men and 37 women, mean age ± standard deviation, 35 ± 15.2 years,) with histopathologically confirmed CD diagnosed based on CT or MRI between January 2010 and May 2017. The CT and MRI findings were analyzed by two radiologists in consensus, and clinical presentation and histopathologic characteristics were documented. Results The CD subtypes included 61 hyaline vascular variant cases (82.4%) and 13 plasma cell variant cases (17.6%). Unicentric CD and multicentric CD were observed in 65 (87.8%) and 9 (12.2%) patients, respectively. On non-enhanced CT, enlarged nodes with hypodensity or isodensity were seen, whereas varying degrees of enhancement were observed in contrast-enhanced CT. Homogeneous and heterogeneous enhancements were observed in 43 (62.3%) and 26 (37.7%) patients, respectively. Hypertrophied vessels and calcification were detected in 38 (51.2%) and 18 (24.3%) patients, respectively. MRI revealed hypointense to isointense lesions on T1-weighted images, isointense to hyperintense lesions on T2-weighted images, and hyperintense lesions on diffusion-weighted imaging; 9 (75%) and 3 (25%) patients demonstrated homogeneous and heterogeneous enhancement, respectively. Conclusion CD often shows well-defined, mildly hypodense or isodense, homogeneous lymph nodules on non-enhanced CT/MRI, with intermediate and marked enhancement on contrast-enhanced CT/MRI. Calcification and hypertrophied vessels may be valuable diagnostic features.

Unicentric Castleman’s Disease Presenting as Retroperitoneal Pelvic Lymph Node in Young Female—Laparoscopic Excision: A Case Report

“…The lesions in case of UCD are larger as compared to MCD [13]. In the present case also the lesion was large as 73 × 49 mm.…”

Different Imaging Features of Retroperitoneal Unicentric Castleman’s Disease: A Case Report

“…In addition, on a multiphase contrast-enhanced scan, it was characterized by significant or obvious enhancement in the arterial phase, portal venous phase, and delayed phase, and by being "early in and late out." Zhao et al [10] found that more than half of their patients had hypertrophied vessels on CT images; moreover, they all had HV CD. Furthermore, the degree of enhancement was not significantly different between the patients with HV CD and those with PC CD [10][11][12].…”

“…Zhao et al [10] found that more than half of their patients had hypertrophied vessels on CT images; moreover, they all had HV CD. Furthermore, the degree of enhancement was not significantly different between the patients with HV CD and those with PC CD [10][11][12]. In our case, CTA showed that the blood supply to the retroperitoneal mass was abundant, which might explain the high uptake of the mass on PET-CT. Zhao et al [10] also found that calcification was observed in all the patients with HV UCD; thus, they thought that calcification and hypertrophied vessels may be valuable diagnostic features of HV UCD.…”

Castelman's disease of the neck: a case report and literature review

“…The hypertrophied vessels are valuable features [ 11 ]. The calcification in affected lesions is not rare and is more commonly observed in hyaline vascular variant unicentric CD [ 12 ].…”