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Chest X Ray Essay

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An 18 year old African American male presented for evaluation of a mediastinal mass seen on chest x ray. He was initially seen in the ED with transient, stabbing, chest pain, which lasted for a few seconds and self-resolved. This prompted evaluation with a chest radiograph. He had no shortness of breath, night sweats, chills, loss of appetite, weight loss, hemoptysis or cough. His past medical history was only significant for seasonal allergies. He had no prior surgeries and had no history of smoking, alcohol or illicit drug use. He was on no medications. Complete physical examination including vital signs and cardiopulmonary exam was normal. Laboratory testing showed a normal complete blood count, biochemistry profiles and he was HIV negative.

A chest radiograph showed a rounded, well-defined soft tissue density measuring 4.5 x 4.2 cm located in the inferior aspect of the left hilum at the level of the mid chest. The chest x-ray was otherwise unremarkable. Computed tomography of the chest revealed a left hilar 3.2 x …show more content…

It can be classified as unicentric (localized) or multicentric (systemic). Unicentric Castleman disease (UCD) has an excellent prognosis, where as multicentric Castleman disease (MCD) is associated with significant morbidity and mortality. MCD occurs most commonly in HIV infected individuals and is associated with human herpesvirus 8 (HHV-8). Although the pathogenesis of CD is not completely understood, interleukin (IL) 6 plays a central role in UCD and both IL-6 and HHV-8 in MCD. Histologically, CD, is usually classified as either the hyaline-vascular (usually occurring in UCD) or plasma cell variant (mostly present in MCD), with occasional cases with mixed features. The diagnosis of CD is made by excisional biopsy or core needle biopsy of affected lymph node tissue. Our patient was HIV negative and the specimen pathology was negative for

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