Korean J Radiol.  2002 Jun;3(2):136-139. 10.3348/kjr.2002.3.2.136.

Imaging Findings of Castleman's Disease Localized in the Axilla: A Case Report

• Seo BK
• Oh YW
• Cho KR
• Lee NJ
• Kim JH
• Kim IS
• Cho SJ
• Bae JW

• KMID: 754074
• DOI: http://doi.org/10.3348/kjr.2002.3.2.136

Abstract

Castleman's disease is a rare benign lymphoproliferative disorder of uncertain origin which most commonly involves the mediastinum but rarely affects the axilla. We report a case of localized Castleman's disease involving the axillary lymph node. Mammography revealed a well-defined, homogeneously dense ovoid mass, 3 cm in size, in the left axilla, while gray-scale ultrasonography (US) demonstrated a well-defined, uniformly hypoechoic ovoid mass with good through transmission. Peripheral hypervascularity was observed at power Dopper US, and early rapid homogeneous enhancement at contrast-enhanced dynamic CT.

Keyword

Lymphatic system, diseases; Lymphatic system, CT; Lymphatic system, US

MeSH Terms

Axilla
Case Report
Female
Giant Lymph Node Hyperplasia/*diagnosis/radiography/ultrasonography
Human
Lymph Nodes/*pathology
Middle Age
*Tomography, X-Ray Computed
*Ultrasonography, Doppler

Figure

• 

  Fig. 1 45-year-old woman with localized Castleman's disease. A. Mediolateral oblique mammogram depicts a well-defined, high-density ovoid mass (arrows) in the left axilla. B, C. Transverse gray-scale US reveals a well-defined, homogeneously hypoechoic ovoid mass with good through transmission (B), while power Doppler US shows that vascularity is more prominent at the periphery than in the central portion of the lymph node. Both linear and branching vascularity are seen along the periphery (C). D-F. At triphasic CT performed after the injection of intravenous contrast material, the lymph node (arrows) appears isodense to chest wall muscle at precontrast scanning (D), shows homogeneous rapid enhancement at the early phase (E), and is washed out at the delayed phase (F). G, H. Pathologic examination revealed characteristic tight concentric layering of lymphocytes at the periphery of the lymphoid follicles, with penetration by small capillaries. The peripheral portion of the node has larger and many more blood vessels (arrows) than the central portion (G) (original magnification, ×4; hematoxylin-eosin staining). In the germinal center, multinucleated and pleomorphic follicular dendritic cells (arrows) are present, indicating follicular dendritic cell dysplasia (H) (original magnification, ×200; hematoxylin-eosin staining).

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