Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Castleman Disease
- Radiologic Findings
- Initial chest radiograph shows mass shadow at left hilum, which has increased on follow up radiograph obtained 4 years later. CT scan shows mass at left left hilum with marked enhancement after contrast injection.
On operation, the mass was broad based on the left major fissure and hypervascular. Pathologic study of the excised mass revealed typical findings of Castleman disease.
- Brief Review
- Castleman disease is a relatively rare disorder of lymphoid tissue, and it is also known as angiofollicular hyperplasia or giant lymph node hyperplasia. The disease may occur anywhere along the lymphatic chain but most commonly is found as a solitary mass in the mediastinum. Two distinct histologic patterns have been described, the hyaline-vascular type, which accounts for 90% of cases, and the plasma cell type accounting for the remainder.
On contrast-enhanced CT, Castleman disease localized to the mediastinum typically shows dense contrast enhancement; any mediastinal compartment can be involved, as can abdominal lymph nodes. Central dense, or flocculent lymph node calcifications can occasionally be seen.
- References
- 1. Moon WK, Im J-G, Kim JS, et al. Mediastinal Castleman disease: CT findings. J Comput Assist Tomogr 1994; 18:43-46
2. McAdams HP, Rosado-de-Christenson M, Fishback NF, Templeton PA. Castleman disease of the thorax: radiologic features with clinical and histopathologic correlation. Radiology 1998; 209:221-228
- Keywords
- Mediastinum, Lymphproliferative disorder,