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Weekly Chest CasesArchive of Old Cases

Case No : 611 Date 2009-07-13

  • Courtesy of Kun Young Lim, Hyae Young Kim, Soo Hyun Lee / National Cancer Center, Korea.
  • Age/Sex 58 / F
  • Chief ComplaintIncidental abnormality on low dose screening CT
  • Figure 1
  • Figure 2

Fig 1

Diagnosis With Brief Discussion

Diagnosis
Castleman's disease (Hyaline vascular type)
Radiologic Findings
Well defined mass is noted anterior to right inferior pulmonary vein on low dose screening CT scan (Fig 1).
Contrast enhanced CT scan shows well enhanced mass anterior to right inferior pulmonary vein (Fig 2). CT attenuation of the mass was 132HU.
Brief Review
Castleman disease is not a distinct disease entity, but rather it is a diverse group of rare lymphoproliferative disorders of differing histopathologic properties and biologic behavior. It is classified into two major subgroups: localized Castleman disease and disseminated Castleman disease. There are two major histologic variants: hyaline-vascular Castleman disease and plasma cell Castleman disease. Most patients with localized thoracic Castleman disease have hyaline-vascular Castleman disease. Localized hyaline-vascular Castleman disease affects individuals of all age groups, with a peak incidence in the fourth decade of life. Female patients are more commonly affected.
On CT images, it manifests as a homogenous or heterogeneous soft tissue mass with marked enhancement. McAdams et al. reported three morphologic patterns: (a) a solitary mass, (b) a dominant infiltrative mass with associated lymphadenopathy, (c) diffuse lymphadenopathy confined to a single mediastinal compartment. Identification of the solitary mass pattern suggests that complete surgical resection is likely.
References
1. 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
Please refer to
Case 56 Case 92 Case 212 Case 253 Case 278 Case 319 Case 374 Case 387 Case 519
Keywords
Mediastinum, Lymphproliferative disorder, Lymphoid hyperplasia,

No. of Applicants : 93

▶ Correct Answer : 36/93,  38.7%
  • - Seoul National University Hospital , Korea (South) Hye Jin Yoo
  • - chp st martin , France Mariotte benoit
  • - CH Sud Rnion , Reunion jean-baptiste Noel
  • - Seoul National University Hospital , Korea (South) Sang Min Lee
  • - EWHA WOMANS MOKDONG UNIVERSITY HOSPITAL , Korea (South) YOOKYUNG KIM
  • - CHRU lille , France manuel toledano
  • - Trakya Univercity School of Medicine , Turkey Armagan Sarac
  • - CHU Grenoble , France Fabrice Bing
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - Samsung Medical Center , Korea (South) Eun Kim
  • - CHRU Lille , France Benjamin Damarey
  • - CHU caen , France nicolas gautier
  • - Seoul National University Bundang Hospital , Korea (South) Kwang Nam Jin
  • - McGill University Health Centre , Canada Amr Ajlan
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - Shinchon Severance Hospital , Korea (South) Ho-Joon Lee
  • - DCA, , India Rajesh Gothi
  • - Shiga University of Medical Science , Japan Norihisa Nitta
  • - Aba Prefecture People Hospital竊ŒSichuan Maerkang竊Œchina , China pu peng
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Hanmaeum Hospital , Korea (South) Kwon Hyoung Kim
  • - IRSA , France jean BIGOT
  • - EKH-Berlin , Germany Michael Weber
  • - The Armed Forces Daegu Hospital , Korea (South) Hyungwoo Oh
  • - Ewha Womans University , Korea (South) Eun Ha
  • - Hopital universitaire Lausanne , Switzerland abed kourhani
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
  • - Bundang CHA hospital , Korea (South) Jung Jin Young
  • - Hopital du SacrCoeur , Canada Abraham Bohadana
  • - Beaulieu clinic Geneva , Switzerland gilles GENIN
  • - Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
  • - Gimpo Woori Hospital , Korea (South) Son Youl Lee
  • - Kangnam Sacred Heart Hospital , Korea (South) Jaewon Kim
  • - PITTWATER RADIOLOGY , Australia Saurabh Khandelwal
  • - PITTWATER RADIOLOGY , Australia Julie Arora
  • - Seoul Nationial University Bundang Hospital , Korea (South) Kyoung Jin Oh
▶ Correct Answer as Differential Diagnosis : 23/93,  24.7%
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OKUBO
  • - PingTung Christian Hospital ,China Medical University ,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
  • - Father Muller Medical College , Mangalore , India nabil mahmood
  • - , Korea (South) Daekeon Lim
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - bmcri , India sanjeev choudri
  • - Doctors Hospital , Bahamas muneesh sharma
  • - Trakya University School of Medicine , Turkey Umut Ugur
  • - NOUR EL-ISLAM RADIOLOGY CENTER , Egypt Elsayed Mousa
  • - Hospital M de Deus , Brazil Thiago Bento da Silva
  • - Dongguk University International Hospital , Korea (South) Ah-young Kim
  • - IRCCS Istituto Oncologico Bari , Italy Carlo Florio
  • - Pusan National University Hospital , Korea (South) YU LI SOL
  • - All India Institute of medical sciences , India Justin Moses
  • - CHUV, Lausanne , Switzerland Andrea Ojanguren
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
  • - SUT Hospital, Trivandrum , India Hari Krishnan
  • - NASA SCANS , India RAKESH BHATIA
  • - Assam medical college , India Karunakaran M
  • - Seoul Nationial University Bundang Hospital , Korea (South) Hee Seok Choi
  • - Kashan University of Medical Sciences, kashan , Iran Ebrahim Razi
  • - kims,narkatpally , India k bhaskar
  • - All India Institute of Medical Sciences , India Ashish Gupta
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