CT features of Castleman disease and pathological analysis

Objective: To analyze the CT features of Castleman disease and correlation with pathology. Methods: Unenhanced (7) and enhanced (6) CT images of 7 pathologically confirmed cases of Castleman disease were reviewed. The disease was classified as localized (6) or disseminated (1) clinically as well as hyaline vascular or plasma cell type histologically. Results: All 6 clinically localized cases were of the hyaline vascular type. CT showed single, round or elliptical masses with intra-tumoral calcification (1 patient), hypodense cystic areas (1) and fascial thickening around the masses (2). All of the masses enhanced with contrast similar to that of large vessels. Numerous hyperplastic lymph follicles and vascular proliferation were detected histologically. One patients with disseminated disease was classified as plasma cell type. CT showed multi-centric enlarged lymph nodes. Histological analysis revealed marked plasma cell proliferation. Conclusion: CT findings of Castleman disease closely correlate with pathology and can aid the diagnosis. (authors)