case_images: PMC4681130_01
case_images: Axial T1-weighted magnetic resonance images without (a) and with (b) gadolinium demonstrating a 7-cm homogeneously enhancing left neck mass circumferentially encasing the left internal carotid artery, extending from C2 to C4. Sagittal (c) and axial (d) T2-weighted magnetic resonance images, again showing the left neck mass encasing the left internal carotid artery
case_images: SNI-6-181-g001.jpg
case_images: PMC4681130_01_SNI-6-181-g001.jpg
case_images: F1
case_images: The initial evaluation consisted of magnetic resonance and computed tomographic (CT) imaging that demonstrated a 7-cm mass with T1 signal and T2 signal contrast enhancement [Figure 1].
case_images: Mid-to-late arterial phase of a left common carotid artery injection before (a) and after coil embolization (b) of the common, internal, and external carotid showing reduced vascularity of the mass
case_images: SNI-6-181-g002.jpg
case_images: PMC4681130_01_SNI-6-181-g002.jpg
case_images: F2
case_images: There was no pedicle large enough to be suitable for embolization [Figure 2].
case_images: (a) Hematoxylin and eosin (H and E) stain at low-power magnification (x40) demonstrating lymph node hyperplasia with vascular proliferation magnification. (b) H and E stain at high-power magnification (x200) showing follicle containing a centrally located single prominent radiating vessel and concentric rings of mantle zone lymphocytes, characteristic of Castleman's lymphadenopathy
case_images: SNI-6-181-g003.jpg
case_images: PMC4681130_01_SNI-6-181-g003.jpg
case_images: F3
case_images: The lymph node showed distinctive features including follicles composed of concentric rings of mantle zone lymphocytes around germinal centers as well as prominent vascularity of the germinal centers, often showing a single penetrating arteriole [Figure 3a and b].