case_images: PMC2713838_01
case_images: 45-year-old woman with localized Castleman's disease.. A. Mediolateral oblique mammogram depicts a well-defined, high-density ovoid mass (arrows) in the left axilla.. B, C. Transverse gray-scale US reveals a well-defined, homogeneously hypoechoic ovoid mass with good through transmission (B), while power Doppler US shows that vascularity is more prominent at the periphery than in the central portion of the lymph node. Both linear and branching vascularity are seen along the periphery (C).. D-F. At triphasic CT performed after the injection of intravenous contrast material, the lymph node (arrows) appears isodense to chest wall muscle at precontrast scanning (D), shows homogeneous rapid enhancement at the early phase (E), and is washed out at the delayed phase (F).. G, H. Pathologic examination revealed characteristic tight concentric layering of lymphocytes at the periphery of the lymphoid follicles, with penetration by small capillaries. The peripheral portion of the node has larger and many more blood vessels (arrows) than the central portion (G) (original magnification, x4; hematoxylin-eosin staining). In the germinal center, multinucleated and pleomorphic follicular dendritic cells (arrows) are present, indicating follicular dendritic cell dysplasia (H) (original magnification, x200; hematoxylin-eosin staining).
case_images: kjr-3-136-g001.jpg
case_images: PMC2713838_01_kjr-3-136-g001.jpg
case_images: F1
case_images: Mediolateral oblique imaging depicted a well-defined ovoid mass, 3 cm in size, in the left axilla (Fig. 1A). Gray-scale US using a broad band linear probe (5-12 MHz) revealed a well-defined, uniformly hypoechoic, ovoid axillary mass, 3x2x3 cm in size and with good through transmission (Fig. 1B). Power Doppler US of the mass showed prominent linear and branching peripheral blood flow (Fig. 1C). At precontrast scanning, the mass was isodense to chest wall muscle (Fig. 1D), while postcontrast scans demonstrated rapid homogeneous enhancement and washout (Figs. 1E and 1F). This showed that in the peripheral portion of the lymph node, the number and size of blood vessels were greater than in the central portion (Fig. 1G), findings which correlated with those of power Doppler US. In the germinal center, multinucleated and pleomorphic follicular dendritic cells were present (Fig. 1H), indicating follicular dendritic cell dysplasia.