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 o...

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Bibliographic Details
Published in:European journal of nuclear medicine and molecular imaging 2020, Vol.47 (1), p.222-223
Main Authors: Fernández-Rodríguez, Paula, Fernández López, Rosa, Acevedo Báñez, Irene, Mohigefer Barrera, Javier, Jiménez-Hoyuela García, José Manuel
Format: Article
Language:English
Subjects:
Adenocarcinoma
Attenuation
Bronchopneumonia
Cardiology
Castleman's disease
Chest
Computed tomography
Diagnosis
Differential diagnosis
Etiology
Hyperplasia
Image of the Month
Imaging
Lesions
Lungs
Lymphoma
Medicine
Medicine & Public Health
Neoplasia
Nuclear Medicine
Oncology
Orthopedics
Parotid gland
Positron emission tomography
Pulmonary lesions
Radioactive tracers
Radiology
Spleen
Tumors
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Summary: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.
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-019-04520-3