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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...

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Autores principales: Panagiotakopoulos, D., Mouchtouris, A., Zarakostas, M., Rontogianni, D., Athanasiadou, P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
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.
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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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