Interleukin-6-producing intravascular large b-cell lymphoma with lymphadenopathy mimicking the histology of multicentric castleman disease

Kohei Shiroshita, Taku Kikuchi, Mikio Okayama, Hidenori Kasahara, Takahiro Kamiya, Takayuki Shimizu, Nozomu Kurose, Yasufumi Masaki, Shinichiro Okamoto

Research output: Contribution to journalArticlepeer-review

Abstract

An inguinal lymph node biopsy of a woman with a one-month history of a progressive fever, fatigue, dyspnea, skin rash, and lymphadenopathy revealed a well-preserved basic structure, hyperplastic germinal centers, and an interfollicular region containing polyclonal plasma cell sheets, suggesting plasma cell-type multicentric Castleman disease (MCD). We initiated prednisolone and anti-interleukin (IL)-6 antibody (tocilizumab), without success. A biopsy specimen re-evaluation detected CD20-positive atypical large B cells infiltrating the small vessels within and around the lymph node and its capsule. We diagnosed her with intravascular large B-cell lymphoma (IVLBCL). Lymphoma cells were weakly positive for IL-6 by immunohistochemical staining. IL-6 from lymphoma cells may have caused the MCD-like presentation as a paraneoplastic etiology. Malignant lymphoma should be excluded before diagnosing MCD.

Original languageEnglish
Pages (from-to)3061-3065
Number of pages5
JournalInternal Medicine
Volume59
Issue number23
DOIs
Publication statusPublished - 2020 Dec 1

Keywords

  • Interleukin-6
  • Intravascular large B-cell lymphoma
  • Multicentric Castleman disease
  • Paraneoplastic syndrome

ASJC Scopus subject areas

  • Internal Medicine

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