대한흉부영상의학회 Weekly Chest Cases

Courtesy of Jin Mo Goo, M.D., Jung-Gi Im, M.D. / Seoul National University Hospital, Seoul, Korea
Age/Sex 44 / F
Chief ComplaintAsymptomatic, Chest radiograph abnormality

Diagnosis: Castleman Disease (Hyaline Vascular Type)
Radiologic Findings: Posteroanterior chest radiograph shows a right paratracheal mass. Contrast-enhanced CT shows right paratracheal lymph node enlargement. CT attenuation of the right paratracheal mass was 100 HU.
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,

대한흉부영상의학회 Korean Society of Thoracic Radiology