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Case report: cobblestone
Multicentric plasma cell variant Castleman’s disease mimicking intrapulmonary malignancy
  1. J Buckley1,
  2. P J Shaw2,
  3. J D Cartledge1,
  4. R F Miller1
  1. 1Department of Sexually Transmitted Diseases, Royal Free and University College Medical School, Camden and Islington Community Health Services NHS Trust, Mortimer Market Centre, London WC1E 6AU, UK
  2. 2Directorate of Imaging, Radiology Department, University College London Hospitals, NHS Trust, London WC1E 6AU, UK
  1. Correspondence to:
 Dr R Miller;
 rmiller{at}gum.ucl.ac.uk

https://doi.org/10.1136/sti.78.4.304

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    Multicentric Castleman’s disease (CD) is an unusual B cell lymphoproliferative disorder in HIV infected individuals,1 and is caused by human herpesvirus 8.

    A 41 year old white homosexual man presented in December 2000 with a 3 month history of weight loss, fevers, slowly progressive cervical lymphadenopathy, and oro-cutaneous Kaposi’s sarcoma. At this time he was found to be HIV-1 antibody positive; baseline investigations showed CD4 count of 120 cells × 106/l, HIV viral load 130 000 copies/ml, Hb = 8.4 g/dl, white blood count = 2.8 × 109/l, and platelet count 118 × 109/l. A bone marrow aspirate showed a hypercellular marrow with marked dysplasia of all three cell lines. These changes were ascribed to HIV infection. A chest radiograph was normal. Antiretroviral therapy with stavudine, lamivudine, and efavirenz, and anti-pneumocystis prophylaxis with co-trimoxazole was …

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