Imaging of Castleman Disease

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Castleman disease (CD) encompasses rare lymphoproliferative disorders.
• CD presents as unicentric (UCD) or multicentric (MCD) forms, differing in presentation and prognosis.
• Both forms involve lymph nodes across various body regions with diverse imaging characteristics.

Purpose of the Study:

• To review the clinical, imaging, and pathological features of Castleman disease.
• To differentiate between unicentric and multicentric Castleman disease based on imaging findings.
• To highlight the role of imaging in diagnosing CD and guiding biopsy and treatment.

Main Methods:

• Review of imaging findings (CT, MRI, PET) in Castleman disease.
• Correlation of imaging features with clinical presentation and pathological confirmation.
• Discussion of treatment strategies for UCD and MCD.

Main Results:

• UCD typically presents as a solitary mass, often in the chest, with well-defined borders and hyperenhancement.
• MCD commonly shows systemic symptoms and involves multiple lymph node chains, potentially with anasarca or hepatosplenomegaly.
• The POEMS subtype of MCD may exhibit osseous lesions; pathological confirmation is crucial for diagnosis.

Conclusions:

• Imaging is vital for suspecting and staging Castleman disease but cannot solely confirm the diagnosis.
• Pathological confirmation via biopsy or excision is necessary.
• Treatment differs significantly between UCD (surgical excision) and MCD (systemic therapy).