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Castleman's disease of the neck: a description of four cases on contrast-enhanced CT

¹ Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore 529889, ² Department of Otolaryngology, Singapore General Hospital, Departments of ³ Diagnostic Imaging, ⁴ Otolaryngology and ⁵ Pathology, KK Women's and Children's Hospital, Singapore

Castleman's disease of the neck is an uncommon benign lymphoproliferative disease that usually presents as homogeneously enhancing enlarged lymph nodes on contrast-enhanced CT scan. We described the appearance of four confirmed cases of Castleman's disease of the neck on contrast-enhanced CT scan. Three of these presented as a solitary enhancing lymph node and the fourth case presented with multiple bilateral enhancing lymph nodes. A central non-enhancing area was present in two of the three cases that presented as a solitary node. Pathological correlation of one of these cases showed that this was due to a central fibrotic scar. One of the enhancing nodes in the fourth case with multiple and bilateral lympadenopathy also contained a central non-enhancing area. We would like to propose that if a central non-enhancing scar is observed in an enhancing lymph node in the neck on CT scan, Castleman's disease should be considered as a possible diagnosis.