title: [A case of multicentric Castleman's disease with metachronous pulmonary and nephric (renal) involvement].
abstract: A 52-year-old woman was referred to our hospital due to cough and sputum in January, 1996. Chest CT scans showed multiple hilar and mediastinal lymphadenopathy and laboratory tests revealed anemia, strong inflammatory reaction, polyclonal hyperimmunoglobulinemia, and an elevated interleukin-6 level. Video-assisted thoracoscopic lung biopsy revealed lymphocytic and plasmacytic infiltration around the bronchovascular band, suggesting a diagnosis of Castleman's disease, and so we began to administer steroids. Although her pulmonary symptoms improved, anemia and hyperimmunoglobulinemia continued. In 2001, her feeling of malaise worsened and gallium scintigraphy revealed new accumulation in her kidneys. Renal biopsy revealed lymphocytic and plasmacytic infiltration mimicking her prior pulmonary involvement. We therefore diagnosed multicentric Castleman's disease with renal involvement. Case in which lymphocytes and plasmacytes infiltrated both the lungs and kidneys metachronously are unusual. We discuss it in relation to the pertinent literature.
authors.affiliation: Department of Respiratory Medicine, Hamamatsu Medical Center.
authors.forename: Hironori
authors.initials: H
authors.lastname: Ashinuma
authors.forename: Norio
authors.initials: N
authors.lastname: Kasamatsu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yano
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shibata
authors.forename: Ikko
authors.initials: I
authors.lastname: Hashizume
mesh_terms: D005871:Castleman Disease / Q000473:pathology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008168:Lung / Q000473:pathology*; D008875:Middle Aged