title: 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.
abstract: 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.
authors.affiliation: Department of Infectious Diseases, National Hospital Organization Osaka National Hospital, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Dai
authors.initials: D
authors.lastname: Watanabe
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Hirota
authors.forename: Motoko
authors.initials: M
authors.lastname: Ikuma
authors.forename: Keishiro
authors.initials: K
authors.lastname: Yajima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kasai
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Mori
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Ota
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nishida
authors.forename: Tomoko
authors.initials: T
authors.lastname: Uehira
authors.forename: Masayuki
authors.initials: M
authors.lastname: Mano
authors.forename: Takahisa
authors.initials: T
authors.lastname: Yamane
authors.forename: Takuma
authors.initials: T
authors.lastname: Shirasaka
mesh_terms: D001853:Bone Marrow / Q000473:pathology; D005871:Castleman Disease / Q000150:complications* / Q000473:pathology / Q000821:virology; D017809:Fatal Outcome; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D019288:Herpesvirus 8, Human / Q000302:isolation & purification; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology*