Rapid Multiorgan Failure due to Large B-cell Lymphoma Arising in Human Herpesvirus-8-associated Multicentric Castleman's Disease in a Patient with Human Immunodeficiency Virus Infection

• Published in: Internal Medicine Vol. 53; no. 24; pp. 2805 - 2809
• Main Authors: Ogawa, Yoshihiko, Watanabe, Dai, Hirota, Kazuyuki, Ikuma, Motoko, Yajima, Keishiro, Kasai, Daisuke, Mori, Kiyoshi, Ota, Yasunori, Nishida, Yasuharu, Uehira, Tomoko, Mano, Masayuki, Yamane, Takahisa, Shirasaka, Takuma
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2014
• Subjects: Bone Marrow - pathology; bone marrow aspiration; Castleman Disease - complications; Castleman Disease - pathology; Castleman Disease - virology; Fatal Outcome; Herpesvirus 8, Human - isolation & purification; HHV-8 MCD; HIV; HIV Infections - complications; HIV Infections - pathology; Human herpesvirus 8; Human immunodeficiency virus; Humans; LBCL; Lymphoma, B-Cell - complications; Lymphoma, B-Cell - pathology; Male; MCD; Middle Aged; Multiple Organ Failure - etiology
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.53.2212

A 46-year-old man presented with a high-grade fever, multiple lymphadenopathies, hepatosplenomegaly and human immunodeficiency virus (HIV) seropositivity, without severe immunosuppression. We suspected human herpesvirus-8 (HHV-8)-associated multicentric Castleman's disease (MCD) based on the results of a physical examination and laboratory investigations, including bone marrow aspiration. However, the patient died eight days after admission due to multiorgan failure. An autopsy revealed MCD and lymphoma cell infiltration in multiple organs. The final diagnosis was large B-cell lymphoma (LBCL) arising in HHV-8-associated MCD. This case illustrates the potential for LBCL in HHV-8 MCD in HIV-infected patients with hepatosplenomegaly and lymphadenopathy without severe immunosuppression and highlights the clinical significance of bone marrow aspiration.