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Castleman disease: the great mimic.

David Bonekamp¹, Karen M Horton, Ralph H Hruban

¹Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, 601 N Caroline St, JHOC 3140C, Baltimore, MD 21287, USA. dboneka1@jhmi.edu

Radiographics : a Review Publication of the Radiological Society of North America, Inc

|October 15, 2011

Summary

Castleman disease is a diverse lymphoproliferative disorder that mimics other conditions. Treatment varies, with surgery for unicentric types and systemic therapies for multicentric Castleman disease.

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Area of Science:

Oncology
Pathology
Radiology

Background:

Castleman disease is a nonclonal lymphoproliferative disorder.
It is a common cause of nonneoplastic lymphadenopathy.
It can affect any body region, mimicking benign and malignant abnormalities.

Purpose of the Study:

To discuss the diverse manifestations of Castleman disease.
To highlight its role in the differential diagnosis of lymphadenopathy.
To review its pathologic variants and associated conditions.

Main Methods:

Review of Castleman disease literature.
Discussion of imaging findings.
Correlation of clinical and pathologic features.

Main Results:

Castleman disease commonly presents as unicentric disease with a hyperenhancing lymph nodal mass.
Pathologic variants include hyaline vascular, plasma cell, and multicentric Castleman disease.
Associated conditions include HIV, lymphoma, POEMS syndrome, and plasma cell dyscrasias.

Conclusions:

Castleman disease requires consideration in the differential diagnosis of lymphadenopathy.
Unicentric hyaline vascular Castleman disease is often curable with surgery.
Multicentric Castleman disease necessitates systemic treatment, including steroids, chemotherapy, or antiproliferative agents.