Morise Masahiro, Shimomoto Hiroshi, Honda Toyohiro, Mori Yoshio
Department of Internal Medicine, Tokai Central Hospital, 4-6-2 Sohara-Higashijima, Kakamigahara-city, Gifu 504-0816, Japan.
Nihon Kokyuki Gakkai Zasshi. 2003 Jan;41(1):59-65.
In a man aged 34 who had been experiencing frequent coughing since November 2001, a chest radiograph showed infiltration shadows in both lung fields. Chest CT showed diffuse centrilobular nodules and multiple mediastinal lymphadenopathy. Laboratory examination revealed high values for C-reactive protein and the erythrocyte sedimentation rate, together with polyclonal hyperimmunoglobulinemia and an elevated interleukin-6 level. We suspected multicentric Castleman's disease, and so performed thoracoscopic mediastinal lymph node biopsy and lung biopsy. The former disclosed follicular hyperplasia and plasma cell infiltration in the interfollicular area, suggesting a diagnosis of Castleman's disease, plasma cell type. The lung biopsy showed heavy infiltration of plasma cells. The diagnosis was therefore multicentric Castleman's disease (MCD) with pulmonary involvement. The chest CT findings were tpical characteristics of pulmonary involvement in patients with MCD.
一名34岁男性自2001年11月起频繁咳嗽,胸部X光片显示双肺野有浸润阴影。胸部CT显示弥漫性小叶中心结节和多个纵隔淋巴结肿大。实验室检查显示C反应蛋白和红细胞沉降率升高,伴有多克隆高免疫球蛋白血症和白细胞介素-6水平升高。我们怀疑是多中心Castleman病,于是进行了胸腔镜纵隔淋巴结活检和肺活检。前者显示滤泡增生和滤泡间区浆细胞浸润,提示诊断为Castleman病,浆细胞型。肺活检显示浆细胞大量浸润。因此诊断为多中心Castleman病(MCD)伴肺部受累。胸部CT表现是MCD患者肺部受累的典型特征。