대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

Diagnosis With Brief Discussion

Diagnosis

Castleman disease

Radiologic Findings

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.
Disseminated Castleman disease is currently regarded as a potentially malignant lymphoproliferative disorder that has been associated POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal proteinemia, and skin changes) syndrome, osteosclerotic myeloma, Kaposi sarcoma, and acquired immunodeficiency syndrome. The patient of presented case had the axonal polyneuropathy, borderline hepatosplenomegaly, diabetes mellitus, hyperpigmentation, and hypertricosis.
CT images obtained after the intravascular administration of contrast material show marked enhancement within the mass. Imaging studies show one of three morphologic patterns: (a) a solitary mass (50%), (b) a dominant infiltrative mass with associated lymphadenopathy (40%), or (c) diffuse lymphadenopathy confined to a single mediastinal compartment (10%).

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,