Pediatric Castleman Disease

  • Etiology: unknown, benign B-cell lymphoproliferative condition
  • Imaging:
    — Unicentric: well defined, hypervascular mass of lymphadenopathy
    — Multicentric: diffuse lymphadenopathy, hepatosplenomegaly, ascites
  • Treatment: surgical for unicentric disease
  • Clinical: 70% in thorax / 10-15% in neck / 10-15% in abdomen, can be unicentric (local) or multicentric (disseminated), usually asymptomatic, can present with painless lymphadenopathy in young adults

Radiology Cases of Castleman Disease

CXR and CT of Castleman disease
CXR AP (above) shows massive bilateral hilar and mediastinal lymphadenopathy. Axial CT with oral contrast and without IV contrast of the chest and abdomen (below) better demonstrates the bilateral hilar and mediastinal lymphadenopathy (lower left) and shows bilateral retroperitoneal adenopathy anterior to the psoas muscles (lower right).