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Giant Coronary Artery Aneurysm in a Patient With Castleman Disease

Abdul Zia1, Morris M Kim2, Sajan S Gill1

  • 1Department of Medicine, Oregon Health and Sciences University (OHSU), Portland, Oregon, USA.

JACC. Case Reports
|August 8, 2025
PubMed

Insights

Giant coronary artery aneurysms (CAAs) exceeding 20 mm are rare but dangerous. This case links a giant CAA in Castleman disease (CD) to inflammation, emphasizing multimodal imaging for diagnosis.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Vascular Biology

Background:

  • Giant coronary artery aneurysms (CAAs), defined as >20 mm, are rare vascular anomalies with severe complications.
  • CAAs are typically associated with atherosclerosis and vasculitis.
  • CAA occurrence in Castleman disease (CD), a rare lymphoproliferative disorder, is exceptionally uncommon.

Observation:

  • A 68-year-old male presented with a large right atrial mass.
  • Diagnostic imaging revealed a giant right coronary artery aneurysm with thrombus.

Findings:

  • This case presents a rare giant CAA associated with Castleman disease.
  • Interleukin-6 (IL-6) may play a role in aneurysm pathogenesis in CD.

Implications:

  • Castleman disease might induce vascular abnormalities through IL-6-mediated inflammation.
  • Multimodal imaging is crucial for diagnosing giant CAAs and guiding treatment.
  • Further research is needed to elucidate the link between IL-6 dysregulation in CD and vascular issues.
Abstract

Keywords:
Castleman diseaseadvanced cardiac imaginggiant coronary artery aneurysminterleukin-6

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