대한흉부영상의학회 Korean Society of Thoracic Radiology GuerBet

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대한흉부영상의학회 Weekly Case 검색
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Weekly Chest CasesArchive of Old Cases

Case No : 92 Date 1999-07-31

  • Courtesy of Eun Joo Ko, M.D. / Nowon EulJi Hospital, Seoul, Korea
  • Age/Sex 40 / M
  • Chief ComplaintRoutine check-up . History of operation due to mediastinal mass ten years before.
  • Figure 1
  • Figure 2

Diagnosis With Brief Discussion

Diagnosis
Castleman's Disease (Angiofollicular hyperplasia, Angiomatous lymphoid hamartoma, Giant lymph node hyperplasia )
Radiologic Findings
CT images obtained after intravenous bolus administration of contrast material show homogeneously enhancing, multiple enlarged lymph nodes in anterior mediastinum and AP window.
Brief Review
Castleman's disease represents a diverse group of lymphoproliferative disorders that are best classified as localized or disseminated.

Patients with localized Castleman's disease are usually asymptomatic, and have the hyaline-vascular type.

Patients with disseminated Castleman's disease usually present with systemic complaints, and have the plasma cell type including some cases of mixed histology.

Disseminated Castleman's disease is currently regarded as a potentially malignant lymphoproliferative disorder that has been associated with POEMS syndrome, osteosclerotic myeloma, Kaposi sarcoma, and AIDS.

Recurrence of Castleman's disease after complete surgical resection is rare but this case revealed recurrence.

Enhancement after the intravenous administration of contrast material is universally reported in the literature. The degree of enhancement is variable and depends on the method (ie, drip versus bolus administration), infusion rate, and total volume of contrast materal injection.
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;2-9:221-228

2. Naidich DP, Webb WR, Muller NL et al. Computed Tomography and Magnetic Resonance of the Thorax. NewYork, Raven Press 1999: 114-116
Keywords
Mediastinum, Benign tumor,

No. of Applicants : 11

▶ Correct Answer : 4/11,  36.4%
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▶ Semi-Correct Answer : 2/11,  18.2%
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