정답: Castleman’s disease Castleman’s disease, hyaline vascular type < Result of immunohistochemistry > CD3: Positive CD20: Positive

Castleman’s disease Rare benign lymphoproliferative disorder of uncertain origin Location chest (70%), neck (<15%), abdomen & pelvis (<15%) Pathophysiology: unknown Lymphoid-hamartomatous hyperplasia Autoimmune phenomena Immunodeficiency Chronic low-grade inflammation David Bonekamp et al. RadioGraphics 2011; 31:1793–180 Toni L. Meador et al. AJR:175, July 2000

Castleman’s disease Hyaline-vascular type Plasma cell type Solitary enlarged lymph node with homogeneous enhancement Solitary well-dermacated mass (m/c: 50%) Dominant infiltrative mass with associated lymphadenopathy (40%) Matted lymphadenopathy without a dominant mass (10%) Prominent feeding vessels Internal calcifications (10%) : discrete, coarse, or branching pattern Plasma cell type Diffuse lymphadenopathy that involves multiple anatomic regions David Bonekamp et al. RadioGraphics 2011; 31:1793–180 Toni L. Meador et al. AJR:175, July 2000

Hyaline vascular type (80%) Castleman’s disease Classification Hyaline vascular type (80%) Plasma cell type (10-20%) Unicentric Multicentric Asymptomatic mass Systemic manifestations: Fever, night sweat, malaise Hematologic and immunologic abnormality Splenomegaly Benign course Worse prognosis Curative surgical resection Systemic chemotherapy Antiproliferative agents: Anti–interleukin 6 (IL-6) receptor therapy Anti–CD20 antibody therapy David Bonekamp et al. RadioGraphics 2011; 31:1793–180 Toni L. Meador et al. AJR:175, July 2000

Castleman’s disease Hyaline-vascular type A solitary enlarged lymph node with homogeneous enhancement Solitary noninvasive mass (m/c: 50%) Dominant infiltrative mass with associated lymphadenopathy (40%) Matted lymphadenopathy without a dominant mass (10%) Prominent feeding vessels David Bonekamp et al. RadioGraphics 2011; 31:1793–180 Toni L. Meador et al. AJR:175, July 2000

Castleman’s disease Hyaline-vascular type A solitary enlarged lymph node with homogeneous enhancement Solitary noninvasive mass (m/c: 50%) Dominant infiltrative mass with associated lymphadenopathy (40%) Matted lymphadenopathy without a dominant mass (10%) Prominent feeding vessels Internal calcifications(10%) : discrete, coarse, or branching pattern David Bonekamp et al. RadioGraphics 2011; 31:1793–180 Toni L. Meador et al. AJR:175, July 2000

Castleman’s disease Plasma cell type Diffuse lymphadenopathy that involves multiple anatomic regions David Bonekamp et al. RadioGraphics 2011; 31:1793–180 Toni L. Meador et al. AJR:175, July 2000