Intracranial dural arteriovenous fistulae are rare, acquired lesions that may present with intracranial haemorrhage or progressive neurological deficits. Their cause is uncertain, although they are often associated with intracranial venous thrombosis. Their importance lies in the fact that they are potentially curable by endovascular or neurosurgical procedures, but easily missed on routine brain imaging. In addition, clinical presentation is variable, with no easily recognisable "syndrome". A high index of suspicion is therefore required, as well as familiarity with the characteristic radiological abnormalities seen on appropriate imaging.
Castleman's disease is a clinicopathological entity associated with lymphoproliferation. We report a case of a 71 year old gentleman who was initially clinically suspected to have lymphoma (owing to clinical features at presentation), but was later histologically confirmed to have Castleman's disease. This case report underlines the importance of definitive histological diagnosis in patients with lympadenopathic presentation associated with systemic symptoms and the distinctiveness of multicentric Castleman's disease from malignant lymphoma. In this report we also attempt to provide new insight (through the review of medical literature) into the clinical features, pathogenesis, diagnosis and treatment of this rare and relatively benign disorder.
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