Unicentric Castleman's Disease of Paraspinal Origin Requiring Differentiation From Schwannoma: Case Report

ABSTRACT Unicentric Castleman's disease (UCD) typically presents as an asymptomatic tumour in the anterior or middle mediastinum. Occurrence in the paravertebral region is comparatively rare and it requires differentiation from neurogenic tumours by imaging. In our patient, preoperative imaging...

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Main Authors: Hazuki Fujimoto, Kayoko Okamura, Shunsuke Tauchi, Rei Tsukamoto, Nanami Kida, Miho Ikeda, Yukihisa Hatakeyama, Hisashi Ohnishi
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Respirology Case Reports
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Online Access:https://doi.org/10.1002/rcr2.70099
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author Hazuki Fujimoto
Kayoko Okamura
Shunsuke Tauchi
Rei Tsukamoto
Nanami Kida
Miho Ikeda
Yukihisa Hatakeyama
Hisashi Ohnishi
author_facet Hazuki Fujimoto
Kayoko Okamura
Shunsuke Tauchi
Rei Tsukamoto
Nanami Kida
Miho Ikeda
Yukihisa Hatakeyama
Hisashi Ohnishi
author_sort Hazuki Fujimoto
collection DOAJ
description ABSTRACT Unicentric Castleman's disease (UCD) typically presents as an asymptomatic tumour in the anterior or middle mediastinum. Occurrence in the paravertebral region is comparatively rare and it requires differentiation from neurogenic tumours by imaging. In our patient, preoperative imaging findings were atypical of schwannoma. Contrast‐enhanced MRI of the thoracic region showed a muscle‐like mass in contact with the pleura on T1‐weighted images. T2‐weighted images showed high signal, especially at the margins. Diffusion‐weighted images showed diffusion restriction around the limbus, and contrast‐enhanced T1‐weighted images displayed strong enhancement of the mass. Diagnosis could not be made preoperatively, although UCD was suspected. Thoracoscopic tumour resection was performed for definitive diagnosis and treatment and postoperative diagnosis was hyaline‐vascular‐type UCD. Diagnosis of neurogenic tumours can be difficult by imaging alone. When imaging findings are atypical, a definitive diagnosis is required, with consideration of the possibility of UCD.
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institution Kabale University
issn 2051-3380
language English
publishDate 2025-01-01
publisher Wiley
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series Respirology Case Reports
spelling doaj-art-fac5b0cf204b4182a0211572d95a34d92025-01-27T09:16:54ZengWileyRespirology Case Reports2051-33802025-01-01131n/an/a10.1002/rcr2.70099Unicentric Castleman's Disease of Paraspinal Origin Requiring Differentiation From Schwannoma: Case ReportHazuki Fujimoto0Kayoko Okamura1Shunsuke Tauchi2Rei Tsukamoto3Nanami Kida4Miho Ikeda5Yukihisa Hatakeyama6Hisashi Ohnishi7Department of Respiratory Medicine Akashi Medical Center Akashi JapanDepartment of Respiratory Medicine Akashi Medical Center Akashi JapanDepartment of Thoracic Surgery Akashi Medical Center Akashi JapanDepartment of Respiratory Medicine Akashi Medical Center Akashi JapanDepartment of Respiratory Medicine Akashi Medical Center Akashi JapanDepartment of Respiratory Medicine Akashi Medical Center Akashi JapanDepartment of Respiratory Medicine Akashi Medical Center Akashi JapanDepartment of Respiratory Medicine Akashi Medical Center Akashi JapanABSTRACT Unicentric Castleman's disease (UCD) typically presents as an asymptomatic tumour in the anterior or middle mediastinum. Occurrence in the paravertebral region is comparatively rare and it requires differentiation from neurogenic tumours by imaging. In our patient, preoperative imaging findings were atypical of schwannoma. Contrast‐enhanced MRI of the thoracic region showed a muscle‐like mass in contact with the pleura on T1‐weighted images. T2‐weighted images showed high signal, especially at the margins. Diffusion‐weighted images showed diffusion restriction around the limbus, and contrast‐enhanced T1‐weighted images displayed strong enhancement of the mass. Diagnosis could not be made preoperatively, although UCD was suspected. Thoracoscopic tumour resection was performed for definitive diagnosis and treatment and postoperative diagnosis was hyaline‐vascular‐type UCD. Diagnosis of neurogenic tumours can be difficult by imaging alone. When imaging findings are atypical, a definitive diagnosis is required, with consideration of the possibility of UCD.https://doi.org/10.1002/rcr2.70099paravertebral regionschwannomaunicentric Castleman's disease
spellingShingle Hazuki Fujimoto
Kayoko Okamura
Shunsuke Tauchi
Rei Tsukamoto
Nanami Kida
Miho Ikeda
Yukihisa Hatakeyama
Hisashi Ohnishi
Unicentric Castleman's Disease of Paraspinal Origin Requiring Differentiation From Schwannoma: Case Report
Respirology Case Reports
paravertebral region
schwannoma
unicentric Castleman's disease
title Unicentric Castleman's Disease of Paraspinal Origin Requiring Differentiation From Schwannoma: Case Report
title_full Unicentric Castleman's Disease of Paraspinal Origin Requiring Differentiation From Schwannoma: Case Report
title_fullStr Unicentric Castleman's Disease of Paraspinal Origin Requiring Differentiation From Schwannoma: Case Report
title_full_unstemmed Unicentric Castleman's Disease of Paraspinal Origin Requiring Differentiation From Schwannoma: Case Report
title_short Unicentric Castleman's Disease of Paraspinal Origin Requiring Differentiation From Schwannoma: Case Report
title_sort unicentric castleman s disease of paraspinal origin requiring differentiation from schwannoma case report
topic paravertebral region
schwannoma
unicentric Castleman's disease
url https://doi.org/10.1002/rcr2.70099
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