US with contrast medium in the diagnosis of abdominal Castleman's disease

Gennaro Annunziata1, Pasquale Martino, Silvano Palazzo

  • 1Dipartimento dell'Emergenza e dei Trapianti di Organi, Università di Bari, Italy.

Insights

Castleman's disease is a rare lymphoproliferative disorder. This review highlights imaging findings, suggesting ultrasound contrast media could aid diagnosis of abdominal Castleman's disease, potentially reducing reliance on CT and MRI.

Area of Science:

  • Oncology
  • Radiology
  • Pathology

Background:

  • Castleman's disease is a rare, heterogeneous lymphoproliferative disorder with uncertain etiology.
  • Abdominal Castleman's disease is uncommon, with retroperitoneal, mesenteric, and pelvic sites reported.
  • Diagnosis is often incidental, identified through imaging modalities like ultrasound (US), CT, and MRI.

Observation:

  • Imaging characteristics of abdominal Castleman's disease were reviewed across 31 cases.
  • Contrast enhancement patterns on CT and MRI varied based on lymph node size: homogeneous for <5 cm and dyshomogeneous for >5 cm.
  • The current case demonstrated similar vascular enhancement behavior on US, CT, and MRI after contrast administration.

Findings:

  • Abdominal Castleman's disease presents with diverse imaging findings.
  • Specific contrast enhancement patterns on CT/MRI correlate with lymph node size.
  • Ultrasound showed comparable vascular enhancement to CT/MRI in the observed case.

Implications:

  • Further research into ultrasound contrast media is warranted for diagnosing abdominal Castleman's disease.
  • Successful validation could reduce the need for CT and MRI in evaluating localized abdominal masses.
  • This may lead to safer, more accessible diagnostic approaches for Castleman's disease.

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