Xiao Lu, Zhang Zhong-lin, Liu Yu-bao, Liu Zai-yi, Li Jing-lei, Yu Yuan-xin, Xie Shu-fei
Department of Radiology, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2011 Jan;31(1):129-32.
To analyze the CT/MRI features of Castleman's disease of the abdomen and pelvis.
CT/MRI images of 6 cases of pathologically confirmed Castleman's disease of the abdomen and pelvis were retrospectively reviewed. All the patients received plain CT scan and dynamic enhanced scan, and one had an additional MR scan.
One case was identified as the disseminated type with multicentric enlarged lymph nodes and hepatosplenomegaly, and 5 cases were found to have localized type, of which 3 had retroperitoneal, 1 had mesentery and 1 had pelvic lesions. On CT scan, all the 5 cases with localized lesions showed single, round or ellipse soft tissue masses, with intra-tumoral calcification in 2 cases, fascial thickening around the mass in 3 cases, and satellite nodules in 4 cases. Enhanced scanning revealed obvious enhancement in the arterial phase and continuous enhancement in the portal vein and delayed phase in all the lesions, with an attenuation pattern similar to that of large vessels; enlarged blood vessels within or around the mass were displayed in each case. In 4 cases, the intra-tumoral radial or fissured non-enhanced areas in early stage of enhancement were gradually filled up as the scan time was delayed. The patient receiving MRI showed hypo-intensity on T(1)WI and hyper-intensity on T(2)WI, presenting with an enhancement feature similar to that of CT.
Castleman's disease in the abdomen and pelvis is rare and liable to misdiagnosis, but its characteristic imaging features can help in the diagnosis and differential diagnosis.
分析腹盆腔Castleman病的CT/MRI特征。
回顾性分析6例经病理证实的腹盆腔Castleman病患者的CT/MRI图像。所有患者均接受了CT平扫及动态增强扫描，其中1例还进行了MRI检查。
1例为多中心淋巴结肿大及肝脾肿大的播散型，5例为局限型，其中3例位于腹膜后，1例位于肠系膜，1例位于盆腔。CT扫描显示，5例局限型病变均表现为单发的圆形或椭圆形软组织肿块，其中2例瘤内有钙化，3例肿块周围有筋膜增厚，4例有卫星结节。增强扫描显示所有病变动脉期明显强化，门静脉期及延迟期持续强化，强化方式与大血管相似；各病例均显示肿块内或周围有增粗的血管。4例在增强早期瘤内呈放射状或裂隙状无强化区，随扫描时间延迟逐渐填充。行MRI检查的患者T(1)WI呈低信号，T(2)WI呈高信号，增强表现与CT相似。
腹盆腔Castleman病少见，易误诊，但其特征性影像表现有助于诊断及鉴别诊断。
