Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2019; 7(8): 1001-1005
Published online Apr 26, 2019. doi: 10.12998/wjcc.v7.i8.1001
Radiologic features of Castleman’s disease involving the renal sinus: A case report and review of the literature
Xiao-Wan Guo, Xu-Dong Jia, Shan-Shan Shen, Hong Ji, Ying-Min Chen, Qian Du, Shu-Qian Zhang
Xiao-Wan Guo, Shan-Shan Shen, Hong Ji, Ying-Min Chen, Shu-Qian Zhang, Department of Radiology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
Xu-Dong Jia, Department of Urology, The Second Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei Province, China
Qian Du, Department of Pathology, Hebei General Hospital, Hebei Province, Shijiazhuang 050051, Hebei Province, China
Author contributions: Guo XW and Zhang SQ designed the research; Jia XD, Shen SS, Ji H, and Qian D collected and confirmed the data; Guo XW wrote the manuscript; Chen YM and Zhang SQ revised the manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: All authors declare no conflicts of interest.
CARE Checklist (2016) statement: “Information for writing a case report” has been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Shu-Qian Zhang, MD, PhD, Chief Doctor, Doctor, Staff Physician, Department of Radiology, Hebei General Hospital, No. 348, Hepingxi Road, Xinhua District, Shijiazhuang 050051, Hebei Province, China. 1247225465@qq.com
Telephone: +86-311-85988016
Received: December 21, 2018
Peer-review started: December 23, 2018
First decision: January 12, 2019
Revised: January 31, 2019
Accepted: February 18, 2019
Article in press: February 18, 2019
Published online: April 26, 2019
Abstract
BACKGROUND

We present a rare case of plasma cell type of Castleman’s disease (CD) involving only the right renal sinus in a 65-year-old woman with a duplex collecting system (DCS).

CASE SUMMARY

The patient presented with a right renal sinus lesion after renal ultrasonography. Subsequent abdominal enhanced computed tomography (CT) and magnetic resonance imaging (MRI) of the kidneys showed DCS and a soft tissue mass with mild enhancement at the lower right renal sinus. The lesion was suspected to be a malignant renal pelvic carcinoma. Hence, the patient underwent a right radical nephrectomy. Histological examination revealed hyperplastic lymphoid follicles in the renal sinus. A detailed review of the patient’s CT and MRI images and a literature review suggested that the lesion was hypointense on T2-weighted images and hyperintense on diffusion-weighted image manifestations, and showed mild enhancement, which distinguished the plasma cell type of CD from many other renal sinus lesions. Furthermore, peripelvic soft tissue masses with a smooth internal surface of the renal pelvis were on imaging findings, which suggests that the urinary tract epithelial system is invulnerable and can be used to differentiate the plasma cell type of CD from malignant lymphoma with a focally growth pattern to some extent.

CONCLUSION

Preoperative diagnosis is often difficult in such cases, as plasma cell type of CD involving only the right kidney is exceedingly rare. However, heightened awareness of this disease entity and its radiographic presentations may alert one to consider this diagnosis.

Keywords: Duplex collecting system, Castleman’s disease, Plasma cell type, Renal sinus, Image, Case report

Core tip: We describe a rare case of plasma cell type of Castleman’s disease (CD) involving only the right renal sinus in a 65-year-old woman with a duplex collecting system. The imaging findings and pathological features of CD involving the renal sinus are summarized in this literature review.