Interleukin-6-producing Intravascular Large B-cell Lymphoma with Lymphadenopathy Mimicking the Histology of Multicentric Castleman Disease
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 plas...
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| Veröffentlicht in: | Internal Medicine 2020/12/01, Vol.59(23), pp.3061-3065 |
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| creator | Shiroshita, Kohei Kikuchi, Taku Okayama, Mikio Kasahara, Hidenori Kamiya, Takahiro Shimizu, Takayuki Kurose, Nozomu Masaki, Yasufumi Okamoto, Shinichiro |
| description | 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. |
| doi_str_mv | 10.2169/internalmedicine.5046-20 |
| format | Article |
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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.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.5046-20</identifier><identifier>PMID: 32759587</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Aged ; B-cell lymphoma ; B-Lymphocytes - pathology ; Biopsy ; Case Report ; Castleman Disease - diagnosis ; Castleman Disease - pathology ; Castleman's disease ; CD20 antigen ; Cytokines ; Diagnosis, Differential ; Dyspnea ; Etiology ; Female ; Fever ; Germinal centers ; Humans ; Interleukin 6 ; Interleukin-6 - biosynthesis ; Internal medicine ; intravascular large B-cell lymphoma ; Lymph nodes ; Lymph Nodes - pathology ; Lymphadenopathy ; Lymphadenopathy - complications ; Lymphadenopathy - pathology ; Lymphatic system ; Lymphocytes B ; Lymphoma, Large B-Cell, Diffuse - complications ; Lymphoma, Large B-Cell, Diffuse - pathology ; Mimicry ; multicentric Castleman disease ; paraneoplastic syndrome ; Prednisolone ; Respiration</subject><ispartof>Internal Medicine, 2020/12/01, Vol.59(23), pp.3061-3065</ispartof><rights>2020 by The Japanese Society of Internal Medicine</rights><rights>Copyright Japan Science and Technology Agency 2020</rights><rights>Copyright © 2020 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c610t-d2691f196deebfeefafd9a2ff83300e6d1489017f0bceeb59e01baa4e899da903</citedby><cites>FETCH-LOGICAL-c610t-d2691f196deebfeefafd9a2ff83300e6d1489017f0bceeb59e01baa4e899da903</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759707/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759707/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,1883,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32759587$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shiroshita, Kohei</creatorcontrib><creatorcontrib>Kikuchi, Taku</creatorcontrib><creatorcontrib>Okayama, Mikio</creatorcontrib><creatorcontrib>Kasahara, Hidenori</creatorcontrib><creatorcontrib>Kamiya, Takahiro</creatorcontrib><creatorcontrib>Shimizu, Takayuki</creatorcontrib><creatorcontrib>Kurose, Nozomu</creatorcontrib><creatorcontrib>Masaki, Yasufumi</creatorcontrib><creatorcontrib>Okamoto, Shinichiro</creatorcontrib><title>Interleukin-6-producing Intravascular Large B-cell Lymphoma with Lymphadenopathy Mimicking the Histology of Multicentric Castleman Disease</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>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.</description><subject>Aged</subject><subject>B-cell lymphoma</subject><subject>B-Lymphocytes - pathology</subject><subject>Biopsy</subject><subject>Case Report</subject><subject>Castleman Disease - diagnosis</subject><subject>Castleman Disease - pathology</subject><subject>Castleman's disease</subject><subject>CD20 antigen</subject><subject>Cytokines</subject><subject>Diagnosis, Differential</subject><subject>Dyspnea</subject><subject>Etiology</subject><subject>Female</subject><subject>Fever</subject><subject>Germinal centers</subject><subject>Humans</subject><subject>Interleukin 6</subject><subject>Interleukin-6 - biosynthesis</subject><subject>Internal medicine</subject><subject>intravascular large B-cell lymphoma</subject><subject>Lymph nodes</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphadenopathy</subject><subject>Lymphadenopathy - complications</subject><subject>Lymphadenopathy - pathology</subject><subject>Lymphatic system</subject><subject>Lymphocytes B</subject><subject>Lymphoma, Large B-Cell, Diffuse - complications</subject><subject>Lymphoma, Large B-Cell, Diffuse - pathology</subject><subject>Mimicry</subject><subject>multicentric Castleman disease</subject><subject>paraneoplastic syndrome</subject><subject>Prednisolone</subject><subject>Respiration</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkc1u1DAUhSMEotPCKyBLbNik2M6vN0gwUFppqm5gbd1JbhJPnTjYTqt5BZ4amxlGULG5lu3Px_eekySE0UvOSvFeTR7tBHrEVjVqwsuC5mXK6bNkxbJcpBXPiufJigpWpzyUs-TcuR2lWV0J_jI5y3hViKKuVsnPmyilcblXU1qmszXtEhR7Es4tPIBrFg2WbMD2SD6lDWpNNvtxHswI5FH54bCDFiczgx_25FaNqrmPEn5Acq2cN9r0e2I6crtorxoMyqoha3Be4wgT-awcgsNXyYsOtMPXx_Ui-X715dv6Ot3cfb1Zf9ykTcmoT1teCtYxUbaI2w6xg64VwLuuzjJKsWxZXgvKqo5um0AUAinbAuRYC9GCoNlF8uGgOy_bYODvfkDL2aoR7F4aUPLfm0kNsjcPsgqmVbQKAu-OAtb8WNB5OSoXnYEJzeIkzzNWB-9FRN8-QXdmiclFqixpUdAyUvWBaqxxzmJ3aoZRGQOXTwOXMXDJ4zBv_h7m9PBPwgG4OwA756HHEwA2RKHxP8pC8izW4xcnshnASpyyX8C-zuM</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Shiroshita, Kohei</creator><creator>Kikuchi, Taku</creator><creator>Okayama, Mikio</creator><creator>Kasahara, Hidenori</creator><creator>Kamiya, Takahiro</creator><creator>Shimizu, Takayuki</creator><creator>Kurose, Nozomu</creator><creator>Masaki, Yasufumi</creator><creator>Okamoto, Shinichiro</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20201201</creationdate><title>Interleukin-6-producing Intravascular Large B-cell Lymphoma with Lymphadenopathy Mimicking the Histology of Multicentric Castleman Disease</title><author>Shiroshita, Kohei ; Kikuchi, Taku ; Okayama, Mikio ; Kasahara, Hidenori ; Kamiya, Takahiro ; Shimizu, Takayuki ; Kurose, Nozomu ; Masaki, Yasufumi ; Okamoto, Shinichiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c610t-d2691f196deebfeefafd9a2ff83300e6d1489017f0bceeb59e01baa4e899da903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>B-cell lymphoma</topic><topic>B-Lymphocytes - pathology</topic><topic>Biopsy</topic><topic>Case Report</topic><topic>Castleman Disease - diagnosis</topic><topic>Castleman Disease - pathology</topic><topic>Castleman's disease</topic><topic>CD20 antigen</topic><topic>Cytokines</topic><topic>Diagnosis, Differential</topic><topic>Dyspnea</topic><topic>Etiology</topic><topic>Female</topic><topic>Fever</topic><topic>Germinal centers</topic><topic>Humans</topic><topic>Interleukin 6</topic><topic>Interleukin-6 - biosynthesis</topic><topic>Internal medicine</topic><topic>intravascular large B-cell lymphoma</topic><topic>Lymph nodes</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphadenopathy</topic><topic>Lymphadenopathy - complications</topic><topic>Lymphadenopathy - pathology</topic><topic>Lymphatic system</topic><topic>Lymphocytes B</topic><topic>Lymphoma, Large B-Cell, Diffuse - complications</topic><topic>Lymphoma, Large B-Cell, Diffuse - pathology</topic><topic>Mimicry</topic><topic>multicentric Castleman disease</topic><topic>paraneoplastic syndrome</topic><topic>Prednisolone</topic><topic>Respiration</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shiroshita, Kohei</creatorcontrib><creatorcontrib>Kikuchi, Taku</creatorcontrib><creatorcontrib>Okayama, Mikio</creatorcontrib><creatorcontrib>Kasahara, Hidenori</creatorcontrib><creatorcontrib>Kamiya, Takahiro</creatorcontrib><creatorcontrib>Shimizu, Takayuki</creatorcontrib><creatorcontrib>Kurose, Nozomu</creatorcontrib><creatorcontrib>Masaki, Yasufumi</creatorcontrib><creatorcontrib>Okamoto, Shinichiro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shiroshita, Kohei</au><au>Kikuchi, Taku</au><au>Okayama, Mikio</au><au>Kasahara, Hidenori</au><au>Kamiya, Takahiro</au><au>Shimizu, Takayuki</au><au>Kurose, Nozomu</au><au>Masaki, Yasufumi</au><au>Okamoto, Shinichiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interleukin-6-producing Intravascular Large B-cell Lymphoma with Lymphadenopathy Mimicking the Histology of Multicentric Castleman Disease</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>59</volume><issue>23</issue><spage>3061</spage><epage>3065</epage><pages>3061-3065</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><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.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>32759587</pmid><doi>10.2169/internalmedicine.5046-20</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged B-cell lymphoma B-Lymphocytes - pathology Biopsy Case Report Castleman Disease - diagnosis Castleman Disease - pathology Castleman's disease CD20 antigen Cytokines Diagnosis, Differential Dyspnea Etiology Female Fever Germinal centers Humans Interleukin 6 Interleukin-6 - biosynthesis Internal medicine intravascular large B-cell lymphoma Lymph nodes Lymph Nodes - pathology Lymphadenopathy Lymphadenopathy - complications Lymphadenopathy - pathology Lymphatic system Lymphocytes B Lymphoma, Large B-Cell, Diffuse - complications Lymphoma, Large B-Cell, Diffuse - pathology Mimicry multicentric Castleman disease paraneoplastic syndrome Prednisolone Respiration |
| title | Interleukin-6-producing Intravascular Large B-cell Lymphoma with Lymphadenopathy Mimicking the Histology of Multicentric Castleman Disease |
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