Follicular dendritic sarcoma within a focus of Castleman's disease. Serial FDG PET/CT in the follow up of recurrence with histopathologic confirmation
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Published on: September 5, 2017
A Iagaru1, C Mari, S Sam Gambhir
1Division of Nuclear Medicine, Stanford University Medical Center, CA, USA.
Abstract:
We report the case of a 30 year-old man with previous history of melanoma and new diagnoses of localized abdominal Castleman's disease with a focus of follicular dendritic sarcoma within the Castleman's tumor. He presented soon after with a single enlarged abdominal lymph node characterized and followed-up by FDG PET/CT as a low grade malignancy consistent with Castleman's recurrence. However, other imaging techniques raised the possibility of sarcoma/ melanoma recurrence. Final surgical resection allowed histological confirmation of the FDG PET/CT findings. To our knowledge, this is one of the few cases in the literature of Castleman's disease and follicular dendritic sarcoma association in the same focus. This is the first paper to our knowledge to use FDG PET/CT as the follow-up imaging tool for serial characterization of recurrence of Castleman's disease and follicular dendritic sarcoma. FDG PET/CT may be useful in the differentiation between Castleman's disease and malignancies associated with this disease.
Insights
This case study highlights a rare association between Castleman's disease and follicular dendritic sarcoma. FDG PET/CT imaging proved effective in monitoring recurrence of these conditions.
Area of Science:
- Oncology
- Diagnostic Imaging
Background:
- Castleman's disease is a rare lymphoproliferative disorder.
- Follicular dendritic sarcoma is an uncommon soft tissue sarcoma.
- Co-occurrence of Castleman's disease and sarcoma is exceptionally rare.
Observation:
- A 30-year-old male with a history of melanoma presented with an enlarged abdominal lymph node.
- Initial imaging suggested malignancy, with FDG PET/CT indicating Castleman's disease recurrence.
- Differential diagnoses included melanoma or sarcoma recurrence based on other imaging modalities.
Findings:
- Histological confirmation revealed Castleman's disease with an interspersed follicular dendritic sarcoma.
- FDG PET/CT was utilized for serial follow-up and characterization of disease recurrence.
- This represents a unique case of co-localized Castleman's disease and follicular dendritic sarcoma.
Implications:
- FDG PET/CT may aid in differentiating Castleman's disease from associated malignancies.
- This study underscores the importance of comprehensive imaging and histological evaluation in complex cases.
- Highlights a rare pathological association and introduces FDG PET/CT as a valuable follow-up tool.
