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Abstract
Case Report
A case of multicentric Castleman's disease with pleural effusion and high levels of adenosine deaminase and IgG4, diagnosed by mediastinal lymph node biopsy
Tatsuki Takahashia Hideto Oshitaa,* Misato Senooa Kunihiko Funaishia Makoto Fujiwarab Ken Okusakia
aDepartment of Internal Medicine, Mihara Medical Association Hospital
bDepartment of Surgery, Mihara Medical Association Hospital
*Present address: Department of Respiratory Internal Medicine, Federation of National Public Service and Affiliated Personnel Mutual Aid Associations, Yoshijima Hospital
ABSTRACT
An 80-year-old man developed bilateral pleural effusion, and fluorodeoxyglucose-positron emission tomography demonstrated increased fluorodeoxyglucose accumulation in the mediastinal and hilar lymph nodes. A mediastinal lymph node biopsy was performed; histopathological analyses of the resected lymph node revealed that small lymphocytes concentrically surrounded the atrophic germinal centers in the lymphoid follicles. Some germinal centers were penetrated by hyalinized vessels. The patient was clinicopathologically diagnosed with multicentric Castleman's disease. Because he had atypical Castleman's disease with a mild inflammatory response and with high levels of IgG4 and adenosine deaminase in pleural effusion, we needed careful differentiation from IgG4-related disease and tuberculous pleurisy.
KEYWORDS
Multicentric Castleman's disease (MCD) IgG4-related disease Pleural effusion Adenosine deaminase (ADA)
Received 30 Dec 2020 ／ Accepted 7 Apr 2021
AJRS, 10(4): 343-347, 2021
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