Case 263

 We present a forty eight-year-old female for diarrhea and epigastric pain. Five days before, she consulted with physician in a local clinic and was given pain killers and antibiotics but in non-effective. Then, she was introduced to our hospital. Laboratory test at admission revealed total protein 6.6g/dL, albumin 2.5g/dL, total bilirubin 2.0 mg/dL, CRP 33.94 mg/dL, white blood cells 10770/mm3, neutrophils 82.6%, lymphocytes 10.1%, platelet 141000/mm3. She received body CT (Figs 1, 2).
 Laboratory test 12 days later revealed total protein 4.7 g/dL, albumin 1.7g/dL, CRP 22.51 mg/dL, white blood cells 12050/mm3, neutrophils 84.5%, lymphocytes 6.0 %, platelet 28000/mm3, fibrinogen 852.2 ng/dL, D dimer 6 μg/dL, IL2R 1740 U/mL (< 496).

What is your imaging diagnosis ?

1.　TAFRO syndrome

2.　Infectious enteritis

3.　POEM syndrome

4.　Unicentric Castleman disease

5.　Multicentric Castleman disease

answer

2022.4.8