Castleman disease - unicentric vascular hyaline type
Presented with multiple oral ulcerative mucosal lesions that were resistant to various treatments.
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Bilobulated and well-defined right axillary mass that shows homogeneous intense enhancement, with a small central hypoattenuating region. Note the presence of some prominent feeding vessels in the posterior aspect of the lesion.
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The radiologic features together with the clinical presentation were highly suggestive for a unicentric Castleman disease associated with paraneoplastic pemphigus.
Surgical excision of the axillary mass was performed and the sample was sent to the anatomopathological analysis. The report described:
"Mix of lymphoid tissue with tumor proliferation of dendritic cells. There are germinal centers surrounded by an expanded mantle area arranged in circular layers ("onion skin" appearence). Also, a marked vascular tumor proliferation with small vessels of hyalinized walls stands out. Findings in keeping with a dendritic follicular cell tumor associated with vascular hyaline Castleman's disease."
After the removal of the Castleman disease mass, the dermatologic lesions progressively remitted.
- David Bonekamp, Karen M. Horton, Ralph H. Hruban, Elliot K. Fishman. Castleman Disease: The Great Mimic. (2011) RadioGraphics. 31 (6): 1793-807. doi:10.1148/rg.316115502 - Pubmed
- Seth J. Kligerman, Aaron Auerbach, Teri J. Franks, Jeffrey R. Galvin. Castleman Disease of the Thorax: Clinical, Radiologic, and Pathologic Correlation: From the Radiologic Pathology Archives. (2016) RadioGraphics. 36 (5): 1309-32. doi:10.1148/rg.2016160076 - Pubmed