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Mediastinal Castleman disease: CT findings
1Department of Radiology, College of Medicine, Seoul National University, Republic of Korea.
Insights
Computed tomography (CT) imaging can help diagnose mediastinal Castleman disease. This study characterized CT findings for hyaline-vascular and plasma cell types of this rare lymphoproliferative disorder.
Area of Science:
- Radiology
- Oncology
- Pathology
Background:
- Castleman disease is a rare lymphoproliferative disorder.
- Mediastinal involvement is less common but significant.
Purpose of the Study:
- To characterize computed tomography (CT) findings in mediastinal Castleman disease.
- To correlate CT features with Castleman disease subtypes.
Main Methods:
- Retrospective review of CT scans from 10 patients with mediastinal Castleman disease.
- Analysis of lesion size, location, enhancement patterns, and calcifications.
Main Results:
- Hyaline-vascular type: well-demarcated, round masses (2-7 cm) with homogeneous enhancement, often in the hilum.
- Calcifications were noted centrally in one hyaline-vascular case.
- Plasma cell type: multiple small, homogeneously enhancing mediastinal and supraclavicular nodes.
Conclusions:
- CT findings can suggest preoperative diagnosis of mediastinal Castleman disease.
- Distinct CT features may help differentiate subtypes.
Objective:
Our objective was to characterize the CT findings of mediastinal Castleman disease.
Materials And Methods:
We reviewed the CT findings of mediastinal Castleman disease in 10 patients.
Results:
In nine cases of hyaline-vascular type Castleman disease, lymph nodes were 2-7 cm in diameter and located in the hilum in six patients, superior mediastinum in two patients, and posterior mediastinum in one patient. On CT the tumors were well-demarcated round masses showing dense homogeneous enhancement after contrast medium injection. Dynamic CT in one case showed gradual centripetal enhancement of the mass. In one case of hyaline-vascular type Castleman disease, lumpy and irregular calcifications were noted in the center of the mass. In the one case of plasma cell type Castleman disease, multiple small homogeneously enhancing nodes were found in the mediastinal and supraclavicular area.
Conclusion:
CT findings may suggest the preoperative diagnosis of mediastinal Castleman disease.