Unusual computed tomography appearance of Castleman disease

Comprehensive analysis of 225 Castleman's diseases in the oral maxillofacial and neck region: a rare disease revisited

OBJECTIVES

The aim of the present study was to comprehensively summarize the epidemiological, clinicopathological characteristics, treatments as well as prognosis of Castleman's disease (CD) identified in the oral maxillofacial and neck region.

MATERIALS AND METHODS

Patients with CD in the oral maxillofacial and neck were retrieved from disease registry at our institution from Jan. 1990 to Dec. 2015. Systematic reviews from both English and Chinese literature were performed to collect the detailed information about the oral maxillofacial and neck CD. The epidemiological, clinicopathological data and treatment outcomes were further statistically analyzed.

RESULTS

Four patients with the oral maxillofacial and neck CD were identified and histologically confirmed as hyaline-vascular type. They underwent surgical excision without recurrence during the follow-up. Systematic literature reviews identified 221 cases from 123 eligible articles which satisfied the inclusion criteria. In 225 patients, most patients were diagnosed as unicentric (207) or hyaline-vascular type (205) of CD and identified in the neck, and treated by surgical resection with good prognosis. In contrast, the minority of patients was multicentric or plasma-cell/mixed type and treated by chemotherapy with inferior outcomes. Kaplan-Meir analyses revealed that both clinical and pathological types were significantly associated with patients' overall survival.

CONCLUSIONS

Although rare, most cases of the oral maxillofacial neck CD are found in adults and classified as unicentric and hyaline-vascular type of CD. Complete surgical excision is preferred with favorable prognosis for unicentric disease, whereas chemotherapy is usually exploited for multicentric disease with inferior outcomes.

CLINICAL RELEVANCE

These data provide comprehensive information about the epidemiology, clinicopathological features, treatments, and outcomes of the oral maxillofacial and neck CD.

CT characteristics of cervical Castleman's disease

Castleman's disease is an uncommon disorder of benign lymph-node hyperplasia. Among all the lesions, less than 10% occurs in the neck. Our case differs from those cases previously reported. Multiple lesions were found on both sides of the neck. Contrast-enhanced CT scan showed dotty and stripy enhancement around these lesions, and rim-like enhancement was also found on delayed scan at 5 min as well. The possibility of Castleman's disease should be considered in multiple cervical masses that show well-defined marked and homogeneous enhancement, especially when stripy enhancement is found around the lesions simultaneously.

Castleman's disease: Report of 4 cases of cervical Lymphadenopathy and review

Castleman's disease is one of the rare causes of cervical lymphadenopathy. A study of 4 cases along with literature review has been done.