Radiologic Features of Castleman's Disease Occupying the Renal Sinus
Akihiro Nishie1,
Kengo Yoshimitsu1,
Hiroyuki Irie1,
Hitoshi Aibe1,
Tsuyoshi Tajima1,
Kenji Shinozaki1,
Tomohiro Nakayama1,
Daisuke Kakihara1,
Seiji Naito2,
Minoru Ono3,
Toru Muranaka4 and
Hiroshi Honda1
1 Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu
University, 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582, Japan.
2 Department of Urology, Graduate School of Medical Sciences, Kyushu University,
Higashi-ku Fukuoka 812-8582, Japan.
3 Department of Radiology, Kitakyushu Municipal Medical Center, 2-1-1, Basyaku,
Kokurakita-ku Kitakyushu 802-0021, Japan.
4 Department of Radiology, National Kyusyu Medical Center, 1-8-1, Jigyohama,
Chuo-ku Fukuoka 810-0065, Japan.
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Fig. 1A. —73-year-old man with mixed form of Castleman's disease in
left renal sinus. Unenhanced CT scan shows mass with slightly higher
attenuation than that of renal parenchyma.
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Fig. 1B. —73-year-old man with mixed form of Castleman's disease in
left renal sinus. CT scan obtained in early phase of enhancement shows mass
with slightly lower attenuation than that of renal parenchyma, although mild
homogeneous enhancement is seen.
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Fig. 1C. —73-year-old man with mixed form of Castleman's disease in
left renal sinus. CT scan obtained in delayed phase shows enhancement of mass
persisting to delayed phase. Mild blunting of calices is seen, and collecting
system (arrow) passes through mass in sinus.
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Fig. 2A. —70-year-old man with plasma cell type of Castleman's disease
in both renal sinuses. Unenhanced CT scan shows masses at bilateral renal
sinus with slightly higher attenuation than that of renal parenchyma and
relatively well-defined margins. Irregular margins are seen on anterior
surfaces of masses.
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Fig. 2B. —70-year-old man with plasma cell type of Castleman's disease
in both renal sinuses. CT scan obtained in early phase of enhancement shows
masses with lower attenuation than renal parenchyma. Mild homogeneous
enhancement is seen. Diffuse and smooth vascular encasement without
irregularity of vascular wall is also detected.
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Fig. 2C. —70-year-old man with plasma cell type of Castleman's disease
in both renal sinuses. CT scan obtained in delayed phase shows enhancement of
mass persisting. Dilatation of proximal renal pelvis is seen, and collecting
system passes through masses in sinus (arrows).
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Fig. 1D. —73-year-old man with mixed form of Castleman's disease in
left renal sinus. T1-weighted image (TR/TE, 131.8/4.5) shows mass with
homogeneous and isohypointense signal relative to that of renal cortex.
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Fig. 1E. —73-year-old man with mixed form of Castleman's disease in
left renal sinus. T2-weighted image (4263/108) shows mass with homogeneous and
hypointense signal compared with that of renal cortex.
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Fig. 1F. —73-year-old man with mixed form of Castleman's disease in
left renal sinus. Arterial phase of left renal arteriogram shows no definite
vascular staining at renal sinus. Left renal artery is patent, and no
irregularity of arterial wall is seen.
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Fig. 1G. —73-year-old man with mixed form of Castleman's disease in
left renal sinus. Venous phase of left renal arteriogram shows that no
definite tumor staining is detected. Left renal vein is patent, and no filling
defect is seen.
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Copyright © 2003 by the American Roentgen Ray Society.
