Castleman disease of the pancreas mimicking pancreatic malignancy on 68Ga-DOTATATE and 18F-fluorodeoxyglucose positron emission tomography/computed tomography: A case report

Figure 1 Preoperative computed tomography of the abdomen. A: A plain computed tomography (CT) scan showed a hyperdense lesion measuring 3.0 cm × 2.0 cm × 2.5 cm in the neck of the pancreas; B: On enhanced CT, the lesion showed significant enhancement in the arterial phase, evenly distributed with smooth and well-defined boundaries; C: In the venous phase, the lesion was gradually washed out.

Figure 2 ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography showing glucose hypermetabolism in the pancreatic mass. A: Axial positron emission tomography/computed tomography (PET/CT); B: Coronal PET/CT; C: Sagittal PET/CT.

Figure 3 ⁶⁸Ga-DOTATATE positron emission tomography/computed tomography revealing slightly elevated somatostatin receptor expression on the pancreatic mass. A: Axial positron emission tomography/computed tomography (PET/CT); B: Coronal PET/CT; C: Sagittal PET/CT.

Figure 4 Specimen photograph and pathological photographs. A: The pancreatic mass with an intact envelope, measuring approximately 3.5 cm × 3 cm; B: Photomicrograph (hematoxylin-eosin stain) suggesting a germinal center with the classic “onionskin” appearance (magnification × 200); C: Immunohistochemistry of CD21 (magnification × 200); D: Immunohistochemistry of Ki-67 (magnification × 200).