Gray-scale and color Doppler sonographic findings in a case of mesenteric Castleman's disease incidentally detected in a patient with Graves' disease

Abstract

We report a case of localized Castleman's disease of mesentery, studied with sonography, that was incidentally detected as an abdominal mass in a patient with Graves' disease. Its lymphatic nature and mesenteric origin was indicated preoperatively on the basis of gray-scale and color Doppler sonographic features.

Sonographic findings of localized Castleman disease of the abdomen and pelvis

“…However, the description of the features of this disorder on US is generally limited to case reports. As previously reported, Castleman disease in the abdomen and pelvis usually appears as a well‐demarcated, homogeneous, hypoechoic mass with occasional cases containing small, hyperechoic internal areas . Unfortunately, the sonographic findings of Castleman disease are nonspecific, and referral for other imaging studies, such as contrast‐enhanced CT and MRI, is required for a more specific imaging diagnosis.…”

“…In most cases, the color Doppler US appearance of Castleman disease has tended to be highly vascular. Loy et al described a case of mesenteric Castleman disease that was characterized on a Doppler sonogram by a large feeding artery entering the hilum. In our study, no such large feeding arteries were identified, but most of our cases did demonstrate marked vascularity on color Doppler US, reflecting hypervascularity of the lesions.…”

Multicentric Castleman’s Disease, Associated with Idiopathic Thrombocytopenic Purpura

“…Some believe it may play a central role in the pathophysiology of CD [12–14]. The association of CD with autoimmune disorders including myasthenia gravis [15], Evans' syndrome [16], vitiligo [17], coeliac disease [18], Graves' disease [19], and ulcerative colitis [20] suggests a possible autoimmune pathology. Of considerable interest, there are two previous reports of the association between CD and immune thrombocytopenia [21, 22].…”

Mediastinal Castleman Disease: Preoperative Radiological Evaluation of Vascularity

“…Ultrasonografik görünümü lenfomaya benzer. Fokal homojen, hipoekoik ve hipervasküler lezyon izlenir [13]. Anjiyografik olarak hiyalin vasküler tipte yoğun vaskülarizasyon dikkat çekip, besleyici arterler ve drenaj venleri izlenir [14].…”

“…T1 ağırlıklı görüntülerde izointens ya da hipointens, T2 ağırlıklı ve kontrastlı T1 ağırlıklı görüntüler-de hiperintens olarak izlenir. Kitle içinde T1 ve T2 ağırlıklı görüntülerde izlenen hipointens alanlar kalsifikasyon, fibröz septa veya vasküler yapılara bağlı olabilir [13,14]. Bizim olgumuzda MRG'de hem kitle içinde hem de çevresinde izlenen tübüler hipointens alanların, BT anjiyografi incelemesi ile birlikte değerlendirildiğinde, besleyici damarlar olduğu görüldü.…”