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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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