18F-FDG PET/CT in lung B lymphoid hyperplasia-type Castleman disease
We present a 62-year-old woman who, after a catarrhal episode, underwent a chest xray and a chest CT, identifying a pleural-based mass in the left lower lobe. This lesion presented a mixed pattern with solid and peripheral ground-glass attenuation, and an air-bronchogram sign. Despite de suspicion of bronchopneumonia, a lung neoplasm like a predominantly lepidic adenocarcinoma could not be ruled. A 18 F-FDG PET/CT showed a focal radiotracer uptake with SUVmax of 5.34 in the pulmonary lesion, supporting the neoplastic etiology. Consequently, a lower lobectomy was performed and histological examination concluded that the final diagnosis was a B lymphoid hyperplasia-type Castleman disease. Castleman’s disease is an uncommon disorder that can be easily misdiagnosed as lymphoma, neoplasm or infection. Unicentric Castleman’s disease (UCD) usually presents a hyaline-vascular histological subtype and is usually asymptomatic. Extranodal involvement is very rare. Only a few cases of solid organ involvement such us spleen or parotid gland have been described. UCD originating in the lung is extremely rare and should be considered in the differential diagnosis of a primary pulmonary malignant tumor.
KeywordsPulmonary mass 18F-FDG PET/CT Unicentric Castleman Disease Hyaline-sclerosing transformation
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Conflict of interest
The authors declare that they have no conflict of interest.
Written informed consent was obtained from the patient for the anonymous use of patient clinical, imaging, and histologic data. All procedures performed in this study involving human participants were in accordance with the ethical standards of the local Ethics and Research Hospital Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.