Zia Abdul, Kim Morris M, Gill Sajan S, Sheikh Omar, Weller Samantha, Bhamipidipati Casti, Rahmouni Hind
Department of Medicine, Oregon Health and Sciences University (OHSU), Portland, Oregon, USA.
Knight Cardiovascular Institute, Portland, Oregon, USA.
JACC Case Rep. 2025 Aug 6;30(22):104572. doi: 10.1016/j.jaccas.2025.104572.
Giant coronary artery aneurysms (CAAs), defined as aneurysms exceeding 20 mm, are rare vascular anomalies with potentially life-threatening complications such as thrombosis, embolization, and rupture. CCAs are typically linked to atherosclerosis and vasculitis, and their occurrence in Castleman disease (CD), a rare lymphoproliferative disorder, is exceedingly rare.
A 68-year-old man presented with a large right atrial mass on echocardiography, later identified on coronary computed tomography angiography and cardiac magnetic resonance imaging as a giant right coronary artery aneurysm with thrombus.
This case highlights a rare presentation of a giant CAA associated with CD and the potential role of interleukin-6 (IL-6) in aneurysm pathogenesis in CD. Additionally, this case underscores the importance of multimodal imaging in diagnosis and management. Further research is needed to explore the link between IL-6 dysregulation in CD and vascular abnormalities.
TAKE-HOME MESSAGES: CD may contribute to vascular abnormalities via IL-6-mediated inflammation. Multimodal imaging is essential for diagnosing giant CAAs and guiding appropriate intervention.
巨大冠状动脉瘤（CAA）定义为直径超过20毫米的动脉瘤，是一种罕见的血管异常，具有潜在危及生命的并发症，如血栓形成、栓塞和破裂。CAA通常与动脉粥样硬化和血管炎有关，其在Castleman病（CD）（一种罕见的淋巴增殖性疾病）中的发生极为罕见。
一名68岁男性经超声心动图检查发现右心房有一个大肿块，随后经冠状动脉计算机断层血管造影和心脏磁共振成像确定为伴有血栓的巨大右冠状动脉瘤。
本病例突出了与CD相关的巨大CAA的罕见表现以及白细胞介素-6（IL-6）在CD动脉瘤发病机制中的潜在作用。此外，本病例强调了多模态成像在诊断和管理中的重要性。需要进一步研究以探索CD中IL-6失调与血管异常之间的联系。
CD可能通过IL-6介导的炎症导致血管异常。多模态成像对于诊断巨大CAA和指导适当干预至关重要。
