The Journal of the Japanese Respiratory Society ONLINE JOURNAL
ABSTRACT
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Article in Japanese
Case Report
A case of pulmonary multicentric Castleman disease which appeared as a very large lesion
Masaki Okamoto1), Tomoaki Hoshino1), Masayuki Nakamura1), Yohei Imamura1), Kiminori Fujimoto2), Koichi Oshima3), Tomotaka Kawayama1) and Hisamichi Aizawa1)
1)Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
2)Department of Radiology, Kurume University School of Medicine
3)Department of Pathology, Kurume University School of Medicine
ABSTRACT
A 31-year-old man visited our hospital with a persistent cough. Computed tomography (CT) scans of his chest showed a very large mass and multiple nodular lesions in the right lung field, mediastinal and hilar lymph node enlargement and splenomegaly. Laboratory analysis showed polyclonal hyperimmunoglobulinemia and increased levels of serum C-reactive protein (14.05 mg/dl) and interleukin-6 (44.2 pg/ml). The pathological findings of lung specimens obtained using video-assisted thoracoscopy revealed hyperplasia of the lymphoid follicles with germinal centers, plasma cell infiltration which stained positively with either anti-κ chain or anti-λ chain antibodies, and fibrosis in the alveolar septum. We made a diagnosis of multicentric Castleman disease based on high levels of serum IL-6, multiple lymph node enlargement and splenomegaly, although this case had histological findings in common not only with Castleman disease but also with inflammatory myofibroblastic tumor. His abnormal chest radiography findings and laboratory data significantly improved 6 months after his first visit, without any treatment. Multicentric Castleman disease showing a very large mass is extremely rare.
KEYWORDS: Multicentric Castleman's Disease (MCD), Inflammatory Myofibroblastic Tumor, Interleukin-6 (IL-6)
RECEIVED: 2010.6.11
JJRS, 49(4): 266-270, 2011
