Presentation
Presented with multiple oral ulcerative mucosal lesions that were resistant to various treatments.
Patient Data
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.
Case Discussion
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 tumour proliferation of dendritic cells. There are germinal centres surrounded by an expanded mantle area arranged in circular layers ("onion skin" appearence). Also, a marked vascular tumour proliferation with small vessels of hyalinized walls stands out. Findings in keeping with a dendritic follicular cell tumour associated with vascular hyaline Castleman's disease."
After the removal of the Castleman disease mass, the dermatologic lesions progressively remitted.
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