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Castleman's disease - a diagnostic dilemma.

Barua A, Vachlas K, Milton R, Thorpe JA - J Cardiothorac Surg (2014)

Bottom Line: Here we describe a caucasian patient who presented with six months history of shortness of breath with CT scan confirming an 8 cm segment of consolidated lung in left hilum.PET scan revealed a mass measuring 68x80x55 mm extending from the left hilum out into the left upper lobe containing area of calcification with SUV max 4.8.The differential diagnosis included atypical sequestration, hamartoma and primary lung malignancy.

View Article: PubMed Central - PubMed

Affiliation: Thoracic Surgery Department, St James's University Hospital NHS Trust, Beckett Street, Leeds, LS97TF, UK. dmcanupama@hotmail.com.

ABSTRACT
Castleman's disease is a benign lymphoproliferative disease characterised by hyperplasia of lymphoid follicles. It can affect any lymph nodes in the body. Here we describe a caucasian patient who presented with six months history of shortness of breath with CT scan confirming an 8 cm segment of consolidated lung in left hilum. PET scan revealed a mass measuring 68x80x55 mm extending from the left hilum out into the left upper lobe containing area of calcification with SUV max 4.8. The differential diagnosis included atypical sequestration, hamartoma and primary lung malignancy. The patient underwent left video assisted enucleation of the lesion. The histology confirmed the diagnosis of Castleman's disease.

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PET scan of the Castleman’s disease.
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Fig2: PET scan of the Castleman’s disease.

Mentions: A 24 year old non-smoking caucasian lady presented with six months history of shortness of breath and productive cough, which did not improve with antibiotics. Clinical examination identified a bilateral significant wheeze. Routine haematological and biochemistry tests were normal. Her FEV1 was 1.6 l (55% predicted) and FVC 3.04 l (92% predicted). CT revealed an 8 cm well demarcated segment of consolidated lung in the left hilum (Figure 1). On PET scan (Figure 2) it was hypermetabolic returning an SUV max 4.8. The radiological appearance was suggestive of sequestration or hamartoma. A CT-guided biopsy was indeterminate and she was therefore referred for surgery. During VATS, the lesion was identified in the left hilum in a haemorrhagic capsule.Figure 1


Castleman's disease - a diagnostic dilemma.

Barua A, Vachlas K, Milton R, Thorpe JA - J Cardiothorac Surg (2014)

PET scan of the Castleman’s disease.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4255971&req=5

Fig2: PET scan of the Castleman’s disease.
Mentions: A 24 year old non-smoking caucasian lady presented with six months history of shortness of breath and productive cough, which did not improve with antibiotics. Clinical examination identified a bilateral significant wheeze. Routine haematological and biochemistry tests were normal. Her FEV1 was 1.6 l (55% predicted) and FVC 3.04 l (92% predicted). CT revealed an 8 cm well demarcated segment of consolidated lung in the left hilum (Figure 1). On PET scan (Figure 2) it was hypermetabolic returning an SUV max 4.8. The radiological appearance was suggestive of sequestration or hamartoma. A CT-guided biopsy was indeterminate and she was therefore referred for surgery. During VATS, the lesion was identified in the left hilum in a haemorrhagic capsule.Figure 1

Bottom Line: Here we describe a caucasian patient who presented with six months history of shortness of breath with CT scan confirming an 8 cm segment of consolidated lung in left hilum.PET scan revealed a mass measuring 68x80x55 mm extending from the left hilum out into the left upper lobe containing area of calcification with SUV max 4.8.The differential diagnosis included atypical sequestration, hamartoma and primary lung malignancy.

View Article: PubMed Central - PubMed

Affiliation: Thoracic Surgery Department, St James's University Hospital NHS Trust, Beckett Street, Leeds, LS97TF, UK. dmcanupama@hotmail.com.

ABSTRACT
Castleman's disease is a benign lymphoproliferative disease characterised by hyperplasia of lymphoid follicles. It can affect any lymph nodes in the body. Here we describe a caucasian patient who presented with six months history of shortness of breath with CT scan confirming an 8 cm segment of consolidated lung in left hilum. PET scan revealed a mass measuring 68x80x55 mm extending from the left hilum out into the left upper lobe containing area of calcification with SUV max 4.8. The differential diagnosis included atypical sequestration, hamartoma and primary lung malignancy. The patient underwent left video assisted enucleation of the lesion. The histology confirmed the diagnosis of Castleman's disease.

Show MeSH
Related in: MedlinePlus