INTRATHORACIC MULTICENTRIC CASTLEMAN-DISEASE - CT FINDINGS IN 12 PATIENTS

Purpose: To assess the computed tomographic (CT) findings of intrathor acic involvement in multicentric Castleman disease. Materials and meth ods: The study comprised 12 patients with lymph node biopsy-proved Cas tleman disease and multicentric involvement. The patients were aged 23 -58 years (mean age, 42.9 years; five men, seven women). Seven patient s underwent open lung biopsy (n = 3) or transbronchial lung biopsy (n = 4), which demonstrated lymphocytic interstitial pneumonitis. Results : All patients had systemic symptoms, polyclonal hypergammaglobulinemi a, and bilateral hilar and mediastinal lymph node enlargement. The nod es a showed mild to moderate enhancement after intravenous administrat ion of contrast material. At thin-section CT, all 12 patients showed p oorly defined centrilobular nodules. Thin-walled cysts were present in 10 patients, thickening of the bronchovascular bundles in 10, and int erlobular septal thickening in nine. Less common findings were subpleu ral nodules, ground-glass attenuation, air-space consolidation, and br onchiectasis. Conclusion: Multicentric Castleman disease is characteri zed by the presence of systemic symptoms, bilateral hilar and mediasti nal lymphadenopathy, and centrilobular nodular opacities. The pulmonar y parenchymal findings are due to the associated lymphocytic interstit ial pneumonitis.