Osteosarcoma Manifesting Systemic Inflammation and Histological Features Mimicking Plasma Cell-type Castleman Disease

Shino Fujimoto; Tomoyuki Sakai; Hiroshi Kawabata; Nozomu Kurose; Sohsuke Yamada; Mariko Doai; Munetaka Matoba; Haruka Iwao-Kawanami; Takafumi Kawanami; Shuichi Mizuta; Toshihiro Fukushima; Hiroki Mizumaki; Masaki Yamaguchi; Yasufumi Masaki

doi:10.2169/internalmedicine.2738-19

CASE REPORTS

Osteosarcoma Manifesting Systemic Inflammation and Histological Features Mimicking Plasma Cell-type Castleman Disease

Shino Fujimoto, Tomoyuki Sakai, Hiroshi Kawabata, Nozomu Kurose, Sohsuke Yamada, Mariko Doai, Munetaka Matoba, Haruka Iwao-Kawanami, Takafumi Kawanami, Shuichi Mizuta, Toshihiro Fukushima, Hiroki Mizumaki, Masaki Yamaguchi, Yasufumi Masaki

Author information

Shino Fujimoto
Department of Hematology and Immunology, Kanazawa Medical University, Japan
Tomoyuki Sakai
Department of Hematology and Immunology, Kanazawa Medical University, Japan
Hiroshi Kawabata
Department of Hematology and Immunology, Kanazawa Medical University, Japan
Nozomu Kurose
Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Japan
Sohsuke Yamada
Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Japan
Mariko Doai
Department of Radiology, Kanazawa Medical University, Japan
Munetaka Matoba
Department of Radiology, Kanazawa Medical University, Japan
Haruka Iwao-Kawanami
Department of Hematology and Immunology, Kanazawa Medical University, Japan
Takafumi Kawanami
Department of Hematology and Immunology, Kanazawa Medical University, Japan
Shuichi Mizuta
Department of Hematology and Immunology, Kanazawa Medical University, Japan
Toshihiro Fukushima
Department of Hematology and Immunology, Kanazawa Medical University, Japan
Hiroki Mizumaki
Department of Hematology, Ishikawa Prefectural Central Hospital, Japan
Masaki Yamaguchi
Department of Hematology, Ishikawa Prefectural Central Hospital, Japan
Yasufumi Masaki
Department of Hematology and Immunology, Kanazawa Medical University, Japan

Keywords: Castleman disease, osteosarcoma, interleukin 6, diagnosis

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 17 Pages 2555-2560

DOI https://doi.org/10.2169/internalmedicine.2738-19

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Abstract

A 73-year-old man was referred to our hospital with a persistent fever, anemia, and a mass in the left pubic region. The findings of biopsy evaluations of the mass and a left inguinal lymph node were consistent with Castleman disease (CD) of plasma cell type. His serum interleukin 6 (IL-6) level was remarkably elevated, supporting the diagnosis of CD. However, imaging analyses revealed destruction of the pubic bone by the mass, which was atypical for CD. Therefore, another deeper biopsy was performed, which finally led to the diagnosis of IL-6-producing osteosarcoma. We conclude that clinicians should carefully exclude malignancies prior to making a CD diagnosis.

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