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Abstract
Castleman disease, or angiofollicular lymph node hyperplasia, is a fairly rare benign tumor of lymphoid origin with unknown etiology. Castleman disease arises mostly in the mediastinum, and some cases of renal and retroperitoneal involvement have been reported. However, Castleman disease that simultaneously involves the kidney and regional lymph nodes has not been reported in radiologic literature. We report a case of renal and pararenal Castleman disease, mimicking renal cell carcinoma with retroperitoneal lymphadenopathy.
Figures and Tables
Fig. 1
A 36-year-old man with Castleman disease involving both kidney and pararenal space.
A. Noncontrast CT of abdomen shows iso to slightly high attenuated mass (black arrow) in the upper pole of the left kidney. And, there are several enlarged lymph nodes (white arrow) at the left pararenal space.
B. Contrast enhanced CT in corticomedullary phase shows homogeneous enhancement of the tumor (black arrow). Note that the several enlarged lymph nodes (white arrow) at left pararenal space demonstrate similar density of enhancement as the mass in the kidney, with Hounsfield unit of 109 and 95-99 in renal mass and lymph nodes, respectively.
C. Contrast enhanced CT in nephrographic phase reveals slow wash out enhancement pattern of the left renal mass (black arrow) and retroperitoneal lymph nodes (white arrow), with Hounsfield unit of 99 and 88-90 in the renal mass and lymph nodes, respectively.
D. Microscopic finding demonstrates increased lymphoid follicles with small germinal centers (black arrows) traversed by hyalinized blood vessels (white arrow). These findings are characteristics of the Castleman disease (Hematoxylin-Eosin, × 200).
References
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