Abstract
BackgroundThe purpose of this study was to determine the contrast-enhanced CT characteristics for differentiating between Castleman disease (CD) and lymphoma in neck lymph nodes.MethodsThis retrospective study evaluated the number (solitary or multiple), strength of contrast-enhancement, type of contrast-enhancement, surrounding vessels, contrast-enhanced Hounsfield unit (HU) values, and anatomical distributions of lymph nodes in 34 patients with confirmed CD and 55 patients with newly diagnosed untreated lymphoma. Independent t-tests, receiver operating characteristic (ROC) curve analysis, and chi-square tests were used to evaluate the variables and CT features.ResultsSeveral significant differences were found between CD and lymphoma. The interval between first contrast-enhanced CT and biopsy/surgery was significantly longer in the CD group (mean 72 ± 105 days, median 60 days) than in the lymphoma patients (mean 30 ± 2 days, median 12 days; p = 0.015). The lymphoma patients presented significantly more often with fatigue and fever (p = 0.023 and p = 0.016 respectively) than did the CD subjects. HU values of nodules after enhancement were significantly higher in the CD patients than in the lymphoma patients. In cases involving multiple lymph nodes, in all the CD cases, all affected nodes were located in only the left or right side of the neck, not bilaterally. ROC analysis showed a significant difference in contrast-enhanced CT attenuation values between lymphoma and CD (p < 0.001, area under the curve = 0.954), with a cut-off value of 92.5 HU. We constructed a decision tree according to these imaging characteristics.ConclusionsContrast-enhanced CT can be useful for differentiating between CD and lymphoma.
Highlights
The purpose of this study was to determine the contrast-enhanced CT characteristics for differentiating between Castleman disease (CD) and lymphoma in neck lymph nodes
The incidence of Castleman disease (CD) has increased in recent years, with this phenomenon having been attributed to factors such as an increase in acquired immunodeficiency syndrome (AIDS), serum interleukin-6 (IL-6) levels, and/or human herpes virus-8 (HHV-8) [1,2,3]
Hounsfield unit (HU) values of nodules after enhancement were significantly higher in the CD patients than in the lymphoma patients
Summary
The purpose of this study was to determine the contrast-enhanced CT characteristics for differentiating between Castleman disease (CD) and lymphoma in neck lymph nodes. CD can mimic other pathology, and especially when it is located in the neck, it often shares similar clinical presentations and imaging characteristics to lymphoma, such as a progressive growing lesion and enlarged lymph nodes on imaging [4, 5]. The two conditions share some similar clinical presentations and imaging characteristics, the treatments for lymphoma and CD are quite different [6, 7]. Very few studies have assessed the diagnostic performance of contrast-enhanced CT for differentiating CD from lymphoma [11,12,13]. The purpose of this study was to compare the characteristics of CD and
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
