CTICasesPlasma Cell Variant of Castleman Disease
Imaging findings
Chest radiograph and CT images demonstrate asymmetric right lower hilar and subcarinal lymphadenopathy. PET imaging shows moderately intense FDG activity within the hilar lymph node mass and milder activity within the subcarinal nodes. Biopsy of the mass reveals the plasma cell variant of Castleman disease, which was negative for human herpesvirus 8.
Key takeaways
Castleman disease is a rare lymphoproliferative disorder classified into hyaline vascular and plasma cell variants. The plasma cell variant is often associated with systemic symptoms and multicentric involvement, and in HHV-8 negative and HIV-negative patients, it presents as a highly vascular, FDG-avid mass that can be challenging to differentiate from other causes of hypervascular lymphadenopathy or histoplasmosis.
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