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Metabolic Characteristics of Castleman Disease on 18F-FDG PET in Relation to Clinical Implication

Lee, Eun Seong MD*; Paeng, Jin Chul MD; Park, Chang Min MD†‡; Chang, Won MD; Lee, Won Woo MD*; Kang, Keon Wook MD*†; Chung, June-Key MD*†; Lee, Dong Soo MD*

doi: 10.1097/RLU.0b013e3182816730
Original Articles

Purpose Castleman disease (CD) is a benign lymphoproliferative disease, which usually shows hypermetabolism on 18F-FDG PET/CT. In this study, we investigated metabolic characteristics of CD in consecutive series of patients and analyzed 18F-FDG uptake with regard to major clinicopathologic factors, to investigate clinical implication of 18F-FDG uptake in CD.

Methods Twelve patients (5 men and 7 women; mean age, 52 ± 14 years) with pathologically confirmed CD, who underwent 18F-FDG PET/CT, were retrospectively enrolled, and their images were analyzed. The cases were composed of 10 first diagnosed and 2 relapsed cases. SUVmax was measured for each lesion. Metabolic characteristics were compared according to clinical and pathologic characteristics.

Results All the 18F-FDG PET/CT images showed hypermetabolic lesions including small lymph nodes of less than 1 cm. The average SUVmax was 5.8 ± 4.1 with a varying range of 2.4 to 17.1. SUVmax was significantly higher in multicentric than in unicentric disease cases (7.0 ± 4.6 vs 3.3 ± 1.1; P = 0.048) and in the patients with clinical manifestation than the other group (7.1 ± 4.5 and 3.1 ± 0.8, respectively; P = 0.028).

Conclusions 18F-FDG PET/CT is an effective diagnostic imaging for diagnosis of CD. Castleman disease shows moderately increased 18F-FDG uptake. In addition, the uptake is well correlated with disease multicentricity and clinical manifestation, suggesting that it would be a significant imaging marker for severity or prognosis of CD.

From the Departments of *Nuclear Medicine and †Cancer Research Institute, and ‡Radiology Institute, Seoul National University College of Medicine, Seoul, Korea.

Received for publication August 31, 2012; revision accepted November 29, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Jin Chul Paeng, MD, PhD, Department of Nuclear Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea. E-mail:; Chang Min Park, MD, PhD, Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea. E-mail:

© 2013 by Lippincott Williams & Wilkins