Contrast-Enhanced Ultrasound in the Diagnosis of Parotid Gland Castleman Disease in a Child.

Castleman disease is a rare lymphoproliferative disorder that infrequently involves the parotid gland. We report a 16-year-old girl with a 3-year history of slowly progressive, painless right cheek swelling. CT and MRI showed an avidly enhancing, markedly T2-hyperintense parotid lesion, suggesting a vascular malformation; fine-needle aspiration yielded reactive lymphoid tissue. Contrast-enhanced ultrasound (CEUS) demonstrated rapid, intense, homogeneous enhancement, confirming a hypervascular solid mass rather than a vascular malformation and raising suspicion for Castleman disease. Superficial parotidectomy confirmed unicentric hyaline-vascular Castleman disease. CEUS aided differentiation of a hypervascular solid lesion from a vascular malformation and narrowed the differential.