Related Experiment Video
Updated: Aug 12, 2026
A Thin-skull Window Technique for Chronic Two-photon In vivo Imaging of Murine Microglia in Models of Neuroinflammation
Published on: September 19, 2010
Imaging features of multicentric Castleman's disease in HIV infection
J C Hillier1, P Shaw, R F Miller
1Clinical Radiology, Chelsea and Westminster Hospital, London, UK. chris_julia.hillier@talk21.com
Insights
Computed tomography (CT) reveals hepatosplenomegaly and enlarged peripheral lymph nodes in human immunodeficiency virus (HIV)-associated Castleman
Area of Science:
- Radiology and Imaging
- Infectious Diseases
- Oncology
Background:
- Castleman's disease is a rare lymphoproliferative disorder.
- Human immunodeficiency virus (HIV) infection is associated with an increased incidence of Castleman's disease, particularly the multicentric form.
- Understanding the imaging features of HIV-associated Castleman's disease is crucial for diagnosis and management.
Purpose of the Study:
- To delineate the characteristic computed tomography (CT) findings in patients with human immunodeficiency virus (HIV)-associated Castleman's disease.
- To correlate CT features with clinical, laboratory, and histopathological findings.
Main Methods:
- Retrospective review of CT scans from nine HIV-positive patients with biopsy-proven Castleman's disease.
- Analysis of clinical data, CD4 counts, and human herpesvirus 8 (HHV8) status.
- Independent review of CT images by two radiologists.
Main Results:
- Common CT findings included splenomegaly (7/9) and peripheral lymphadenopathy (axillary 8/9, inguinal 4/9).
- Enlarged lymph nodes demonstrated mild to avid enhancement post-contrast.
- Hepatomegaly (7/9) and abdominal/mediastinal lymphadenopathy were also frequent; pulmonary abnormalities were seen in 4/9 patients.
Conclusions:
- Hepatosplenomegaly and peripheral lymphadenopathy are common CT features of multicentric Castleman's disease in HIV infection.
- While suggestive in the correct clinical context, these findings lack specificity, necessitating biopsy for definitive diagnosis.
- The plasma cell variant is most common in HIV-associated Castleman's disease, with universal splenomegaly and a strong association with Kaposi's sarcoma.
Aim:
To describe the computed tomography (CT) features of human immunodeficiency virus (HIV)-associated Castleman's disease.
Materials And Methods:
Nine HIV-positive patients with biopsy-proven Castleman's disease were studied. Clinical and demographic data, CD4 count, histological diagnosis and human herpes type 8 (HHV8) serology or immunostaining results were recorded. CT images were reviewed independently by two radiologists.
Results:
CT findings included splenomegaly (n=7) and peripheral lymph node enlargement (axillary n=8, inguinal n=4). All nodes displayed mild to avid enhancement after intravenous administration of contrast material. Hepatomegaly was evident in seven patients. Other features included abdominal (n=6) and mediastinal (n=5) lymph node enlargement and pulmonary abnormalities (n=4). Patterns of parenchymal abnormality included bronchovascular nodularity (n=2) consolidation (n=1) and pleural effusion (n=2). On histological examination eight patients (spleen n=3, lymph node n=9, lung n=1, bone marrow n=1) had the plasma cell variant and one had mixed hyaline-vascular/plasma cell variant. The majority had either positive immunostaining for HHV8 or positive serology (n=8).
Conclusion:
Common imaging features of multicentric Castleman's disease in HIV infection are hepatosplenomegaly and peripheral lymph node enlargement. Although these imaging features may suggest the diagnosis in the appropriate clinical context, they lack specificity and so biopsy is needed for diagnosis. In distinction from multicentric Castleman's disease in other populations the plasma cell variant is most commonly encountered, splenomegaly is a universal feature and there is a strong association with Kaposi's sarcoma.
