"T1: iso to hyperintense relative to skeletal muscle"
"T1 C+ (Gd): shows enhancement"
"T2: arborising calcification may be seen as low signal"
"DWI/ADC: hyperintense at diffusion-weighted imaging - low ADC values may be encountered 13,14"
"Lymph nodes or masses typically demonstrate mild to moderately hypermetabolic activity at PET/CT 21."
"The condition was first described by an American pathologist, Benjamin Castleman (1906-1982) in 1954 4,20."
"human herpes virus-8 (HHV-8)-associated (often in HIV-positive individuals) (HHV8-MCD)"
"POEMS syndrome-associated MCD (POEMS-MCD)"
"Multicentric Castleman disease, on the other hand, occurs in an older population (fifth and sixth decades), with no gender preference 15,21. It has several risk factors, which differ according to the subtype. HIV is a relevant risk factor for this condition, and it has been demonstrated that all patients with HIV and multicentric Castleman disease are coinfected with the human herpesvirus 8 (HHV-8)."
"The disease is of unknown aetiology, but the most widely accepted theory is that Castleman disease is a chronic low-grade inflammatory process. The interleukin 6 in unicentric Castleman disease and both interleukin-6 and HHV-8 in multicentric Castleman disease are demonstrated to play a critical role in pathogenesis and symptomatology of the disease 15."
"TAFRO-MCD: an MCD variant associated with thrombocytopenia, anasarca, fever, bone marrow reticulin fibrosis (or renal insufficiency), and organomegaly (hepatosplenomegaly and lymphadenopathy)"
"POEMS syndrome"
"osseous lesions are common in POEMS-associated MCD, with commonly sclerotic lesions, or less commonly lytic or mixed osseous lesions"
"PET-CT is a useful modality for the diagnosis of Castleman disease, it aids in the selection of the most suitable node for biopsy (relying on the size and the maximum standardised uptake value (SUVmax)). It also helps to demonstrate the extent of disease, and allow follow-up and monitoring of patients with proved Castleman disease 21."
"Multicentric Castleman disease may be treated with any combination of surgery, chemotherapy and prednisolone 6. Available treatments include also antiviral strategies (targeting HHV-8), and monoclonal antibody therapies targeting CD20 or IL-6 15. The prognosis is relatively poorer."
"Patients with multicentric Castleman disease and POEMS syndrome are usually treated with high-dose immunosuppressive agents and steroids. If immunosuppression fails, autologous peripheral blood stem cell transplantation is recommended 19."
"systemic infections (CMV-, HIV-, or EBV-associated disorders)"
"Kaposi sarcoma"
Expected headings
"Associations"
"For mediastinal lesions: CT chest"
"For abdominal lesions: CT abdomen"
"For multicentric disease: multi-region CT"
"There are two distinct subtypes of Castleman disease:"
"The disease is characterised by hypervascular lymphoid hyperplasia. There is two main subtypes; the hyaline vascular variant (HVV) and the plasma cell variant (PCV). Cases that show overlapping features are termed mixed type 21."
"Multicentric Castleman disease has an exuberant clinical presentation due to the systemic inflammation, with symptoms such as fevers, night sweats, fatigue, and weight loss, and clinical signs of generalised lymphadenopathy, hepatosplenomegaly, and fluid retention (anasarca)."
"extranodal sites are uncommon but possible, including the lungs, pleura, pericardium, adrenal gland, larynx, retropharyngeal space, parotid glands, pancreas, meninges, muscles, and bones 21"
"The disease is characterised by hypervascular lymphoid hyperplasia. There is two main subtypes; the hyaline vascular variant (HVV) and the plasma cell variant (PCV). Cases that show overlapping features are termed mixed type 21."
"calcifications in Castleman disease are relatively rare, with variable pattern of calcification, including dense, coarse or may have an arborising pattern"
"Multicentric Castleman disease may be treated with any combination of surgery, chemotherapy and prednisolone 6. Available treatments include also antiviral strategies (targeting HHV-8), and monoclonal antibody therapies targeting CD20 or IL-6 15. The prognosis is relatively poorer."