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Zuo R, Xu L, Pang H. 68Ga-DOTATATE and 68Ga-Pentixafor PET/CT in a Patient with Castleman Disease of the Retroperitoneum. Diagnostics (Basel) 2024; 14:372. [PMID: 38396411 PMCID: PMC10888364 DOI: 10.3390/diagnostics14040372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
This is a case of a 42-year-old man with recurrent symptoms of dizziness and a newly found retroperitoneal mass with no 131I-MIBG uptake who was referred for restaging with 68Ga-DOTATATE PET/CT and local 68Ga-pentixafor PET/CT. The examinations both showed intense radioactivity uptake in the retroperitoneal mass and no abnormal uptake in the right adrenal nodule. Two lesions showed distinct properties of radioactivity uptake, which suggested the possibility of different sources. A postoperative pathological test revealed that the morphology and immunohistochemistry of the retroperitoneal mass was found to be consistent with Castleman disease, and the right adrenal gland was normal tissue.
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Affiliation(s)
| | | | - Hua Pang
- Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing 400016, China; (R.Z.); (L.X.)
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Sachan A, Singh P, Kaushal S, Kumar R. Castleman disease masquerading as a paraganglioma showing uptake on DOTATATE PET. BMJ Case Rep 2023; 16:e253385. [PMID: 37648276 PMCID: PMC10471861 DOI: 10.1136/bcr-2022-253385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
A man in his 50s presented with shortness of breath and was found to have a large paracaval mass, which on further evaluation with CT, showed a large heterogeneously enhancing mass lesion adjacent to right renal hilum. His 24-hour urinary metanephrines and nor-metanephrines were normal. In view of location and features on CT, paraganglioma was considered as a possibility. A 68Ga-DOTATATE positron emission tomography/CT demonstrated avidity in the lesion with maximum standardised uptake value of 16.5. He underwent right laparoscopic converted to open mass excision along with nephrectomy. Histopathological examination was suggestive of hyaline vascular Castleman disease.
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Affiliation(s)
- Ankit Sachan
- Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Prashant Singh
- Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Seema Kaushal
- Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Rajeev Kumar
- Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Umrigar N, Kotecha K, Gill AJ, Mittal A, Samra J. A sheep in wolf's clothing: Castleman disease masquerading as a neuroendocrine tumour. ANZ J Surg 2023; 93:1423-1424. [PMID: 36602086 DOI: 10.1111/ans.18260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 01/06/2023]
Affiliation(s)
- Natasha Umrigar
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Krishna Kotecha
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Anthony J Gill
- Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.,NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Anubhav Mittal
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.,School of Medicine, University of Notre Dame Sydney, Sydney, New South Wales, Australia
| | - Jaswinder Samra
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
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Liu SL, Luo M, Gou HX, Yang XL, He K. Castleman disease of the pancreas mimicking pancreatic malignancy on 68Ga-DOTATATE and 18F-fluorodeoxyglucose positron emission tomography/computed tomography: A case report. World J Gastrointest Surg 2022; 14:514-520. [PMID: 35734619 PMCID: PMC9160689 DOI: 10.4240/wjgs.v14.i5.514] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/01/2022] [Accepted: 05/07/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Castleman disease is an uncommon nonclonal lymphoproliferative disorder, which frequently mimics both benign and malignant abnormalities in several regions. Depending on the number of lymph nodes or regions involved, Castleman disease (CD) varies in diagnosis, treatment and prognosis. It rarely occurs in the pancreas alone without any distinct clinical feature and tends to be confused with pancreatic paraganglioma (PGL), neuroendocrine tumors (NETs), and primary tumors, thus impeding proper diagnosis and treatment.
CASE SUMMARY A 28-year-old woman presented with a lesion on the neck of the pancreas, detected by ultrasound during a health examination. Physical examination and laboratory findings were normal. The mass showed hypervascularity on enhanced computed tomography (CT), significantly increased 18F-fluorodeoxyglucose uptake on positron emission tomography (PET)/CT, and slightly increased somatostatin receptor (SSTR) expression on 68Ga-DOTATATE PET/CT, suggesting no distant metastases and subdiagnoses such as pancreatic PGL, NET, or primary tumor. Intraoperative pathology suggested lymphatic hyperplasia, and only simple tumor resection was performed. The patient was diagnosed with the hyaline vascular variant of CD, which was confirmed by postoperative immunohistochemistry. The patient was discharged successfully, and no recurrence was observed on regular review.
CONCLUSION High glucose uptake and slightly elevated SSTR expression are potentially new diagnostic features of CD of the pancreas.
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Affiliation(s)
- Sheng-Lu Liu
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Ming Luo
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Hao-Xian Gou
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Xiao-Li Yang
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Kai He
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
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Zhai HY, Zhu XY, Zhou GM, Zhu L, Guo DD, Zhang H. Unicentric Castleman disease was misdiagnosed as pancreatic mass: A case report. World J Clin Cases 2022; 10:1278-1285. [PMID: 35211560 PMCID: PMC8855184 DOI: 10.12998/wjcc.v10.i4.1278] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/16/2021] [Accepted: 12/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Castleman’s disease (CD) is a lymphatic proliferative disorder of unknown cause and is rarely seen clinically. It has been divided into unicentric and multicentric types. Unicentric CD (UCD) occurs as a solitary enlarged mass and mediastinal lymph nodes are the most common site. Surgical excision has proven to be curative for UCD. Multicentric CD (MCD) appears as a systemic disease with peripheral lymphadenopathy. MCD had a poor response to surgery and monoclonal antibodies with rituximab have become a research hotspot.
CASE SUMMARY A 44-year-old woman presented with a pancreatic mass during routine physical examination. She had no obvious symptoms, such as fever, abdominal pain, abdominal distension, or jaundice. Ultrasound examination indicated a hypoechoic mass between the body of the pancreas, left lobe of the liver and stomach. It had a clear boundary, irregular shape, uneven echo, and no obvious blood flow signals. To clarify the diagnosis, contrast-enhanced ultrasound examination was performed, which showed a benign pancreatic lesion. Neuroendocrine or solid pseudopapillary tumor was a possible diagnosis. The patient underwent further contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging, which were suggestive of solid pseudopapillary tumor or neuroendocrine tumor. All the examinations failed to give a definitive diagnosis, and the patient underwent surgery. The final pathological and immunohistochemical results showed that the mass was CD.
CONCLUSION This case highlights when lymphadenopathy is encountered clinically, CD should be considered and a biopsy should be performed.
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Affiliation(s)
- Hong-Yan Zhai
- Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin 300005, China
| | - Xin-Yuan Zhu
- Department of Cardivascular, Tianjin Medical University General Hospital, Tianjin 300005, China
| | - Gui-Ming Zhou
- Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin 300005, China
| | - Li Zhu
- Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin 300005, China
| | - Dan-Dan Guo
- Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin 300005, China
| | - Hao Zhang
- Department of Cardivascular Surgery, Tianjin Medical University General Hospital, Tianjin 300005, China
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Gunda D, Naughton J, Stevens SG, Perini MV. Castleman's disease masquerading as pancreatic neuroendocrine tumour. BMJ Case Rep 2021; 14:14/6/e242597. [PMID: 34167983 DOI: 10.1136/bcr-2021-242597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Castleman's disease (CD) is a rare lymphoproliferative disorder. This case report, to the best of our knowledge, is the first report of CD simulating a pancreatic neuroendocrine tumour . The patient was a 58-year-old woman who initially presented with bilateral iritis and underwent investigation for possible systemic rheumatological disease. CT of the chest demonstrated an incidental finding of a well-demarcated retropancreatic mass. As the mass was found to enhance on DOTATATE (tetraazacyclododecanetetraacetic acid-DPhe1-Tyr3-octreotate) positron emission tomography, a diagnosis of pancreatic neuroendocrine tumour was made. The patient underwent an open distal pancreatectomy and splenectomy. Histopathological examination revealed the unexpected diagnosis of hyaline vascular CD of a lymph node posterior to the pancreas. After 2 years of follow-up, there is no evidence of disease recurrence.
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Affiliation(s)
- Deepika Gunda
- Department of Surgery, Austin Health, Heidelberg, Victoria, Australia
| | - Jack Naughton
- Department of Surgery, Austin Health, Heidelberg, Victoria, Australia
| | - Sean Gregory Stevens
- Department of Surgery, Austin Precinct, University of Melbourne, Melbourne, Victoria, Australia
| | - Marcos V Perini
- Department of Surgery, Austin Health, Heidelberg, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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