161 Non-Neoplastic Lymphadenopathy: Multicentric Castleman Disease

Clinical Presentation

28-year-old man with malaise, fever, night sweats, skin lesions, and palpable supraclavicular lymphadenopathy

Radiologic Findings

Contrast-enhanced chest CT (mediastinal window) (Figs. 161.1, 161.2) demonstrates multiple borderline enlarged mediastinal and right internal mammary lymph nodes and enlarged right axillary lymph nodes which exhibit intense contrast enhancement.

Diagnosis

Multicentric Castleman Disease

Differential Diagnosis

• Metastatic Disease

• Lymphoma

• Angioimmunoblastic Lymphadenopathy

Fig. 161.1

Fig. 161.2 (Reproduced with permission from Parker MS. Multicentric hyaline-vascular Castleman disease. Clin Radiol 2007; 62:707–710.)

Discussion

Background

Castleman disease, also known as angiofollicular or giant lymph node hyperplasia, is a rare lymphoproliferative disorder characterized by lymph node enlargement with extensive capillary proliferation. Two forms of Castleman disease are recognized, localized or unicentric (the most common) and multicentric or disseminated

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