Johkoh T, Müller N L, Ichikado K, Nishimoto N, Yoshizaki K, Honda O, Tomiyama N, Naitoh H, Nakamura H, Yamamoto S
Department of Radiology, Osaka University Medical School, Japan.
Radiology. 1998 Nov;209(2):477-81. doi: 10.1148/radiology.209.2.9807577.
To assess the computed tomographic (CT) findings of intrathoracic involvement in multicentric Castleman disease.
The study comprised 12 patients with lymph node biopsy-proved Castleman disease and multicentric involvement. The patients were aged 23-58 years (mean age, 42.9 years; five men, seven women). Seven patients underwent open lung biopsy (n = 3) or transbronchial lung biopsy (n = 4), which demonstrated lymphocytic interstitial pneumonitis.
All patients had systemic symptoms, polyclonal hypergammaglobulinemia, and bilateral hilar and mediastinal lymph node enlargement. The nodes showed mild to moderate enhancement after intravenous administration of contrast material. At thin-section CT, all 12 patients showed poorly defined centrilobular nodules. Thin-walled cysts were present in 10 patients, thickening of the bronchovascular bundles in 10, and interlobular septal thickening in nine. Less common findings were subpleural nodules, ground-glass attenuation, air-space consolidation, and bronchiectasis.
Multicentric Castleman disease is characterized by the presence of systemic symptoms, bilateral hilar and mediastinal lymphadenopathy, and centrilobular nodular opacities. The pulmonary parenchymal findings are due to the associated lymphocytic interstitial pneumonitis.
评估多中心Castleman病胸腔内受累的计算机断层扫描（CT）表现。
本研究纳入12例经淋巴结活检证实为Castleman病且有多中心受累的患者。患者年龄23 - 58岁（平均年龄42.9岁；男性5例，女性7例）。7例患者接受了开胸肺活检（n = 3）或经支气管肺活检（n = 4），结果显示为淋巴细胞间质性肺炎。
所有患者均有全身症状、多克隆高球蛋白血症以及双侧肺门和纵隔淋巴结肿大。静脉注射对比剂后，淋巴结呈轻度至中度强化。在薄层CT上，12例患者均显示边界不清的小叶中心结节。10例患者有薄壁囊肿，10例有支气管血管束增粗，9例有小叶间隔增厚。较少见的表现为胸膜下结节、磨玻璃影、实变影和支气管扩张。
多中心Castleman病的特征为存在全身症状、双侧肺门和纵隔淋巴结肿大以及小叶中心结节状混浊。肺实质表现归因于相关的淋巴细胞间质性肺炎。
