Castleman's disease presenting as an adnexal mass: ultrasound, CT and MRI features

Castleman's disease is a rare benign lymphoproliferative disorder of unknown aetiology. Castleman first described this disease entity also known as angiomatous lymphoid hamartoma or giant lymph node hyperplasia in 1954 in a group of patients with mediastinal lymphadenopathy [1]. Castleman's disease most commonly occurs in the thorax (70%), but can be seen in any location where lymphoid tissue is present and even in areas devoid of lymphoid tissue such as the central nervous system [2]. Castleman's disease in the pelvis is rare with only a few cases reported in the literature [3-6]. Imaging of Castleman's disease by CT has been well described in the literature, but MR reports on this disease are scarce [7, 8] and no cases of pelvic Castleman's disease have been reported using MRI with gadolinium. We describe one case of pelvic Castleman's disease imaged by three cross-sectional modalities: ultrasound (US), CT and MRI with gadolinium. An additional case of Castleman's disease of the pelvis is described that included both US and CT with coronal and sagittal reformations. To our knowledge, no case report has been published so far that used three cross-sectional imaging modalities or multiplanar reformations for assessing vascular supply in masses due to pelvic Castleman's disease.