CTICasesMulticentric Castleman Disease (Plasma Cell Variant)
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Imaging findings
PET-CT showed diffuse abnormal FDG uptake in skeletal tissues, around the heart, spine, and within the chest. CT revealed enhancing soft tissue in the anterior mediastinum, superficial to the pericardium, and paraspinal tissue. Lung windows showed small peripheral ground-glass nodules in the upper lobes, smaller areas inferiorly, and ill-defined calcified nodules. Biopsy of the anterior fascial tissue confirmed plasma cell variant of Castleman disease.
Key takeaways
Multicentric Castleman disease, particularly the plasma cell variant, can present with systemic constitutional symptoms and extranodal soft tissue infiltration in areas like the mediastinum and paraspinal regions, in addition to lung nodules. The differential diagnosis for such infiltrating soft tissue masses, especially with systemic symptoms, includes IgG4-related sclerosing disease.
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