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Endosonographic features of unicentric Castleman Disease
BACKGROUND: Castleman disease (CD) is a rare lymphoproliferative disorder most frequently occurring in the mediastinum. Peripancreatic forms are less frequent. Few cases of endoscopic ultrasonography-fine-needle aspiration (EUS-FNA) findings of this lesion have been reported, where no real-time tiss...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4569904/ https://www.ncbi.nlm.nih.gov/pubmed/26425506 |
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author | Panagiotakopoulos, D. Mouchtouris, A. Zarakostas, M. Rontogianni, D. Athanasiadou, P. |
author_facet | Panagiotakopoulos, D. Mouchtouris, A. Zarakostas, M. Rontogianni, D. Athanasiadou, P. |
author_sort | Panagiotakopoulos, D. |
collection | PubMed |
description | BACKGROUND: Castleman disease (CD) is a rare lymphoproliferative disorder most frequently occurring in the mediastinum. Peripancreatic forms are less frequent. Few cases of endoscopic ultrasonography-fine-needle aspiration (EUS-FNA) findings of this lesion have been reported, where no real-time tissue elastography (RTTE) has been described in the literature to our knowledge. METHODS: We describe the endosonographic, elastographic, cytologic and immunocytochemistry findings in two cases of unicentric CD of the hyaline vascular variant. RESULTS: Two females, aged 41 and 34 year were referred to our hospital for further EUS evaluation of a peripancreatic mass found incidentally on computed tomography. EUS examination revealed around, well-demarcated, uniformly hypoechoic mass measuring 52 and 23 mm respectively, with smaller adjacent hypoechoic lymph nodes. Doppler examination revealed intense peripheral vascularity, together with prominent penetrating feeding vessels entering a distinct hilum. RTTE revealed a relatively homogenous soft elastographic pattern. EUS-FNA provided smears with clusters of lymphocytes in a hemorrhagic background. Cell block preparation showed immature lymphocytes surrounding lymphocyte-poor centers with vascular proliferation. Immunohistochemical staining of the cell block sections showed CD45-leukocyte common antigen, CD20, CD23, CD79a, Bcl-2 and CD5 positivity in small lymphocytes. Cytology was suggestive of non-Hodgkin's lymphoma. Surgical excision was performed in both cases and histopathology was consistent with CD of the hyaline vascular type. CONCLUSION: The echo features of a solitary hypoechoic homogenous well-demarcated mass with prominent vasculature and increased elasticity should raise the possibility of unicentric CD. EUS-FNA usually cannot make a definitive distinction from certain kinds of lymphoma. |
format | Online Article Text |
id | pubmed-4569904 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-45699042015-09-30 Endosonographic features of unicentric Castleman Disease Panagiotakopoulos, D. Mouchtouris, A. Zarakostas, M. Rontogianni, D. Athanasiadou, P. Endosc Ultrasound EURO EUS Meeting BACKGROUND: Castleman disease (CD) is a rare lymphoproliferative disorder most frequently occurring in the mediastinum. Peripancreatic forms are less frequent. Few cases of endoscopic ultrasonography-fine-needle aspiration (EUS-FNA) findings of this lesion have been reported, where no real-time tissue elastography (RTTE) has been described in the literature to our knowledge. METHODS: We describe the endosonographic, elastographic, cytologic and immunocytochemistry findings in two cases of unicentric CD of the hyaline vascular variant. RESULTS: Two females, aged 41 and 34 year were referred to our hospital for further EUS evaluation of a peripancreatic mass found incidentally on computed tomography. EUS examination revealed around, well-demarcated, uniformly hypoechoic mass measuring 52 and 23 mm respectively, with smaller adjacent hypoechoic lymph nodes. Doppler examination revealed intense peripheral vascularity, together with prominent penetrating feeding vessels entering a distinct hilum. RTTE revealed a relatively homogenous soft elastographic pattern. EUS-FNA provided smears with clusters of lymphocytes in a hemorrhagic background. Cell block preparation showed immature lymphocytes surrounding lymphocyte-poor centers with vascular proliferation. Immunohistochemical staining of the cell block sections showed CD45-leukocyte common antigen, CD20, CD23, CD79a, Bcl-2 and CD5 positivity in small lymphocytes. Cytology was suggestive of non-Hodgkin's lymphoma. Surgical excision was performed in both cases and histopathology was consistent with CD of the hyaline vascular type. CONCLUSION: The echo features of a solitary hypoechoic homogenous well-demarcated mass with prominent vasculature and increased elasticity should raise the possibility of unicentric CD. EUS-FNA usually cannot make a definitive distinction from certain kinds of lymphoma. Medknow Publications & Media Pvt Ltd 2014-04 /pmc/articles/PMC4569904/ /pubmed/26425506 Text en Copyright: © Endoscopic Ultrasound http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | EURO EUS Meeting Panagiotakopoulos, D. Mouchtouris, A. Zarakostas, M. Rontogianni, D. Athanasiadou, P. Endosonographic features of unicentric Castleman Disease |
title | Endosonographic features of unicentric Castleman Disease |
title_full | Endosonographic features of unicentric Castleman Disease |
title_fullStr | Endosonographic features of unicentric Castleman Disease |
title_full_unstemmed | Endosonographic features of unicentric Castleman Disease |
title_short | Endosonographic features of unicentric Castleman Disease |
title_sort | endosonographic features of unicentric castleman disease |
topic | EURO EUS Meeting |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4569904/ https://www.ncbi.nlm.nih.gov/pubmed/26425506 |
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