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Weekly Chest CasesArchive of Old Cases

Case No : 1391 Date 2024-06-19

  • Courtesy of Kyongmin Sarah Beck / Seoul St. Mary’s Hospital
  • Age/Sex 40 / M
  • Chief Complaintpalpable right inguinal mass
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6
  • Figure 7

Diagnosis With Brief Discussion

Diagnosis
Castleman disesase (plasma cell type)
Radiologic Findings
Fig 1-7. Chest CT with lung setting and mediastinal setting shows numerous ill-defined nodules with ground-glass opacities and diffuse irregular interlobular septal thickening in B lung and multiple enlarged or mildly enlarged LNs in bilateral supraclavicular fossae, bilateral axillae, mediastinum, and bilateral hila.
Brief Review
Castleman disease is a non-clonal lymphoproliferative disorder and one of the more common causes of nonneoplastic lymphadenopathy. Histopathologically, Castleman disease can be classified into hyaline vascular type and plasma cell type. Hyaline vascular type and plasma cell type represents 90% and 10% of Castleman disease, respectively.
Plasma cell Castleman disease more frequently occurs as multicentric Castleman disease. CT manifestations include diffuse lymphadenopathy involving multiple anatomic regions, including bilateral hilar and mediastinal lymphadenopathy and diffuse thoracic, abdominal, pelvic, or cervical lymphadenopathy. Diffuse nodular opacities, ground-glass opacities, interlobular septal thickening, and bronchovascular bundle thickening are seen in the lungs and sometimes mistaken as lymphoproliferative disease or sarcoidosis.
References
1. Bonekamp D, Horton KM, HrubanRH, et al. Castleman disease the greast mimic. Radiographics 2011 ;31 :1793-1807.
2. Nishimura MF, Igawa T, Gion Y, et al. J Pers Med. 2020 Dec; 10(4): 269.
Keywords

No. of Applicants : 61

▶ Correct Answer : 15/61,  24.6%
  • - The University of Tokyo Hospital , Japan JUN KANZAWA
  • - Kyoto City Hospital , Japan YUSUKE UTSUNOMIYA
  • - , Korea (South) DONG-HO BANG
  • - Healthy Longevity Medical Center , Japan SHIN-ICHI CHO
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Other , Korea (South) SEONGSU KANG
  • - University of Yamanashi , Japan HIROYUKI MORISAKA
  • - , Japan YOSHIKI ISHII
  • - University of Yamanashi , Japan HIROAKI WATANABE
  • - , Japan SHUNJIRO NOGUCHI
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Korea University Anam Hospital , Korea (South) KYU-CHONG LEE
  • - Hyogo Prefectural Kobe Children , Japan SHUHEI NORIMOTO
  • - Kantou Rousai Hospital , Japan KAORU SUMIDA
  • - Toyota Kosei Hospital , Japan YUKI HAYASHI
▶ Correct Answer as Differential Diagnosis : 10/61,  16.4%
  • - medical scanning , Japan HIROAKI ARAKAWA
  • - Secomedic Hospital , Japan FUMINORI MIYOSHI
  • - University of Yamanashi , Japan TAKAAKI HASHIMOTO
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Osaka Metropolitan University Hospital , Japan SHU MATSUSHITA
  • - Shiga General Hospital , Japan YUSAKU MORIBATA
  • - Other , Korea (South) SEOL A LEE
  • - Kyoto University , Japan SHO KOYASU
  • - The Catholic University of Korea Yoeuido St. Mary , Korea (South) CHAWOONG JEON
  • - Juntendo University , Japan YUTAKA IKENOUCHI
▶ Semi-Correct Answer : 23/61,  37.7%
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Shiga University of Medical Science , Japan AKITOSHI INOUE
  • - Kyoto University , Japan AKIHIKO SAKATA
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - NIMS, HYDERABAD , India BHASKAR K
  • - , Korea (South) JIN YOUNG LEE
  • - Oita University, Faculty of Medicine , Japan FUMITO OKADA
  • - , Korea (South) KANGHWI LEE
  • - Osaka University , Japan AKINORI HATA
  • - Other , Korea (South) HYEJOO PARK
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - , Japan KENTARO KOTANI
  • - Kyoto University Hospital , Japan YASUHISA KURATA
  • - Other , Korea (South) CHAEHUN LIM
  • - Jichi Medical University, School of Medicine , Japan MITSURU MATSUKI
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - Osaka metropolitan university Hospital , Japan TATSUSHI OURA
  • - Mie university , Japan SHIKO OKABE
  • - GHICL , France MANUEL TOLEDANO
  • - , Sweden MOHAMAD TLASS
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - University of Yamanashi , Japan KOJIRO ONOHARA
  • - Jiangsu province hospital , China WANGJIAN ZHA
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