PMC2667582_01
A 62-year-old man with esophageal Castleman disease.. A. Spot radiograph from a single-contrast esophagogram reveals a 6-cm filling defect (arrows) arising from the lateral esophageal wall.. B. Coronal reformation CT image shows a definite extent of the disease.. C, D. Axial CT images, before (C) and after contrast injection (D), display focal thickening in the anterior wall of the lower esophagus, with circumferential luminal air, and the intramural mass shows homogeneous enhancement.. E. Endoscopy reveals a smoothly bulging mass with smooth surface and focal reddish coloration on the distal esophagus.. F. Macroscopy of the excised tumor demonstrates a multilobulated mass with whitish color and smooth margin without hemorrhage or necrosis.. G, H. Microscopically, the esophageal mass reveals nodular lymphoid areas, a marked expansion of the mantle zone, and small, relatively inconspicuous germinal centers (H & E staining, x10). The follicles show marked vascular proliferation with hyalinization (H & E staining, x200).
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F1
A double-contrast esophagography showed a 2.5x6 cm polypoid mass arising in the distal esophageal wall, located just above the gastroesophageal junction (Fig. 1A). CT depicted no lymph node enlargement in the mediastinum or upper abdomen (Figs. 1B-D). The surface of the proximal portion of the tumor was slightly reddish, but smooth and covered with normal mucosa (Fig. 1E). On sectioning, the mass had a yellowish gray multinodular appearance (Fig. 1F). Microscopically, the esophageal mass revealed nodular lymphoid areas, a marked expansion of the mantle zone, and small, relatively inconspicuous germinal centers (Fig. 1G). The follicles show marked vascular proliferation with hyalinization (Fig. 1H).