A novel diagnostic tool for hyaline vascular Castleman disease versus lymphoma based on contrast-enhanced computed tomography in neck mass

Q: What is the study’s main diagnostic goal?

To quantitatively evaluate imaging findings and distinguish unicentric Castleman disease from lymphoma in the neck using contrast-enhanced CT Hounsfield units (HU).

Q: How were HU measurements performed in this research?

Preoperative contrast-enhanced CT images were reviewed, and the HU of each tumor were measured to compare quantitative outcomes between the two diseases.

Q: What key CT-HU difference supports diagnosis?

Enhancement in Castleman disease was higher than in lymphoma, and the study reports a linear HU relationship in Castleman disease that was not noted in lymphoma.

Sep 29, 2026

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Castleman disease and lymphoma require distinct treatment strategies yet can show overlapping imaging appearances on contrast-enhanced computed tomography. Quantitative assessment of differences was performed by measuring tumor Hounsfield units (HU) on preoperative contrast-enhanced CT in patients with unicentric Castleman disease and lymphoma confirmed by pathology. In retrospective analysis, enhancement differed significantly between groups, and HU behavior supported an accurate differential diagnosis for neck lymph nodes.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages4

Reading Time10 min

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Abstract

Introduction

Methods

J Chin MedAssoc Original article A novel diagnostic tool for hyaline vascular Castleman disease versus lymphoma based on contrast-enhanced computed tomography in neck mass Huan-Yu Lina,b, Pei-Shao Liaoa,b, Liang-Chun Shiha,b,*, Chun-Hung Huaa,b, Ming-Hsui Tsaia,b, Chia-Der Lina,b aDepartment of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan, ROC; bDepartment of Otolaryngology-Head and Neck Surgery, School of Medicine, China Medical University Hospital, Taichung, Taiwan, ROC Abstract Background: Castleman disease and lymphoma each have a distinct treatment plan; however, they share the same features on contrast-enhanced computed tomography. Methods: To assess the quantitative outcomes of Castleman disease versus lymphoma using contrast-enhanced computed tomography based on Hounsfield units (HU) . We retrospectively reviewed eight patients with unicentric Castleman disease and 30 patients with lymphoma based on pathological diagnosis at China Medical University Hospital between 2015 and 2020. Preoperative computed tomography with contrast scans was reviewed, and the HU of each tumor were measured. Results: This study included eight patients with unicentric Castleman disease (four men and four women; mean age, 33 years) and 25 patients with lymphoma (11 men and 14 women; mean age, 53 years) . There was no significant difference in heterogeneity between the two diseases (0 .161 ± 0.052 vs 0.239 ± 0.063, p = 0.22); however, enhancement in Castleman disease was higher than that in lymphoma (126 .40 ± 31.90 vs 74.19 ± 7. 11, p < 0.001), providing a very good diagnostic tool (cutoff point at 88.5–91.3, sensitivity 0.86/specificity 0 .88) . Furthermore, we found a highly linear relationship in Castleman disease, which was not noted in lymphoma. Conclusion: The value of HU provides a good diagnostic tool for the differential diagnosis of Castleman disease versus lymphoma in the neck lymph nodes. Considering the linear relationship in Castleman disease, an increasingly accurate differential diagnosis can be made. Keywords: Castleman disease; Computed tomography; Lymphoma 1. INTRODUCTION Castleman disease is a lymphoproliferative disorder first reported by Dr. Benjamin Castleman in 1954. It is also known as giant lymph node hyperplasia or angiofollicular lymph node hyperplasia. Although the etiology of Castleman disease remains unclear, the disease is classified into two subtypes, unicentric and multicentric,1,2 with the former being more prevalent. Unicentric Castleman disease is characterized by a painless mass over the mediastinum, axillary, and cervical lymph nodes and nonspecific clinical presentations,3 with radiographic features that demonstrate intense homogeneous enhancement following contrast on CT (CT).4–6 However, lymphomas share the *Address correspondence. Dr. Liang-Chun Shih, Department of OtolaryngologyHead and Neck Surgery, China Medical University Hospital, 2, Yude Road, Taichung 404, Taiwan, [ROC. E-mail address: entdrshih7111@gmail.com](ROC. E-mail address: entdrshih7111@gmail.com) (L.-C. Shih). Author contributions: Dr. Huan-Yu Lin and Dr. Pei-Shao Liao contributed equally to this work. Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2022) 85: 935-938. Received October 31, 2021; accepted February 7, 2022. doi: 10. 1097/JCMA.0000000000000778. Copyright © 2022, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/)) same features of intense homogeneous enhancement on CT.7,8 One retrospective study found significantly higher Hounsfield units (HU) in patients with Castleman disease than in patients with lymphoma.9 Ho

FAQs

What is the study’s main diagnostic goal?

To quantitatively evaluate imaging findings and distinguish unicentric Castleman disease from lymphoma in the neck using contrast-enhanced CT Hounsfield units (HU).

How were HU measurements performed in this research?

Preoperative contrast-enhanced CT images were reviewed, and the HU of each tumor were measured to compare quantitative outcomes between the two diseases.

What key CT-HU difference supports diagnosis?

Enhancement in Castleman disease was higher than in lymphoma, and the study reports a linear HU relationship in Castleman disease that was not noted in lymphoma.

Sep 29, 2026

Upload by Putri