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HHV-8-associated multicentric Castleman disease with concurrent Kaposi sarcoma
  1. Julia L Boland1,
  2. Jennifer Kate Beckerman1,
  3. Brian T Hanyok2,
  4. Esma Akin2 and
  5. Zoe McKinnell3
  1. 1Internal Medicine, The George Washington University Hospital, Washington, District of Columbia, USA
  2. 2Radiology, The George Washington University Hospital, Washington, District of Columbia, USA
  3. 3Hematology Oncology, The George Washington University Hospital, Washington, District of Columbia, USA
  1. Correspondence to Dr Julia L Boland; jboland{at}gwu.edu

Abstract

Multicentric Castleman disease (MCD) is a rare lymphoproliferative disorder typically manifesting with bulky lymphadenopathy in multiple lymph node stations. We describe an atypical presentation of human herpes virus 8 (HHV8)-associated MCD in a middle-aged man with no significant medical history who presented with 1 month of systemic symptoms. He was found to be HIV-1 positive. A physical examination did not reveal palpable lymphadenopathy. A contrast-enhanced CT scan was notable for hepatosplenomegaly and mildly enlarged scattered lymph nodes in the abdomen and pelvis. A positron emission tomography/CT scan demonstrated hypermetabolic cervical chain lymph nodes. Posterior cervical lymph node pathology showed HHV8-positive MCD with concurrent HIV-associated Kaposi sarcoma. The patient was treated with rituximab and liposomal doxorubicin without response. We emphasise the lack of the hallmark of bulky lymphadenopathy in this patient, and the importance of a timely pathological diagnosis in MCD.

  • HIV / AIDS
  • Chemotherapy
  • Haematology (incl blood transfusion)
  • Infectious diseases
  • Radiology

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Footnotes

  • Contributors JB participated in acquisition and analysis of the data, and drafting and submission of the final manuscript. JKB, BH, Esma Akin and ZM participated in analysis of the data and drafting of the final manuscript. All authors gave final approval to the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.