Castleman's Disease of the Transverse Mesocolon Presenting Accumulation of 18F-Fluorodeoxyglucose Imaged by Positron Emission Tomography: A Case Report

Shusuke Mori, Koutarou Sasahara, Katsunori Tauchi and Kayoko Higuchi*

Department of Surgery and Department of Pathology*, Aizawa Hospital

A 78 year-old woman referred for abdominal discomfort and a solitary abdominal mass demonstrated by computed tomography (CT) in an initial workup was further found in CT to have a well-enhanced 26×22 mm solitary mass with a distinct margin and soft tissue contents to the left of the umbilicus beneath the abdominal wall. Positron emission tomography (PET) showed an accumulation of 18F-fluorodeoxyglucose (FDG) based on the location of the mass demonstrated by CT and its standardized uptake value was 4.0. Operative findings showed a thumb-tip-sized solitary mass in the transverse mesocolon, necessitating partial transverse colectomy including the mass. Macroscopically, the spherical 30×20 mm mass was covered by a white capsula containing light brownish solid substances. Microscopic findings showed the mass to be a lymph node with hyperplasia of the lymph follicles, infiltration of plasma cells, and hyalinization of vessel walls. Immunohistochemistry indicated a mixture of kappa-positive and lambda-positive plasma cells, indicating no monoclonal proliferation of plasma cells, histologically compatible with Castleman's disease.

Key words
Castleman's disease, FDG-PET, mesentery

Reprint requests
Shusuke Mori Department of Surgery, Aizawa Hospital
2-5-1 Honjou, Matsumoto, 390-8510 JAPAN

Accepted
January 30, 2008

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