A lymph node lesion of hyper IL-6 syndrome mimicking plasmacytoma, IgG4-related disease, and Castleman disease
A 72-year-old male patient presented fatigue, anemia, elevated total protein, IgG, IgG4, IL-6, and vascular endothelial growth factor (VEGF) levels. Initial diagnostics suspected multiple myeloma. A plane computed tomography (CT) scan showed pneumonia and the enlargement of generalized lymph nodes. A lymph node biopsy revealed a mix of immature and mature plasma cells, significant IgG4-positive cells, and IL-6-secreting plasma cells, mimicking plasmacytoma, IgG4-related disease, and Castleman disease, ultimately leading to a diagnosis of hyper IL-6 syndrome. Treatment with antibiotics improved the patient's condition without the need for additional therapies, including tocilizumab.
Authors
- Kenta Matsui (ORCID: https://orcid.org/0000-0002-4357-590X)
- Keiki Kawakami (ORCID: https://orcid.org/0000-0001-9729-8162)
- Toshiaki Kobayashi (ORCID: https://orcid.org/0000-0001-8435-3724)
- Yasuharu Sato (ORCID: https://orcid.org/0000-0001-5234-6861)
- Miki Usui (ORCID: https://orcid.org/0000-0001-7083-0067)
- Minoru Mizutani
- Hiroshi Imai (ORCID: https://orcid.org/0000-0003-0738-3633)
- Kennosuke Karube (ORCID: https://orcid.org/0000-0002-1205-858X)
- Midori Filiz Nishimura (ORCID: https://orcid.org/0000-0002-8433-4870)
- Tetsuya Murata
- M. Okada
Institutions
- Okayama University (JP)
- Mie University Hospital (JP)
- Nagoya University (JP)
Publication Details
- Journal
- Journal of Clinical and Experimental Hematopathology
- Published
- 2024-12-24
- DOI
- https://doi.org/10.3960/jslrt.24039
- Primary Topic
- Lymphoma Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00