Figure 2

A 34-year-old man was diagnosed with multicentric Castleman disease of plasma cell variant after 11 years. He was complained of multiple superficial lymphadenopathy and intermittent low-grade fever for 11 years and exertional dyspnea for 4 months. His local multiple biopsies showed lymph node reactive hyperplasia. Short-term prednisone and repeated kinds of antibiotics were prescribed for him but his symptoms recurred. In our hospital, erythrocyte sedimentation rate (ESR) was 140 mm/h and IgG was 133 g/l, which was polycolonal. His high resolution chest CT showed multiple cysts and nodules, consolidations, diffuse bronchovascular thickening (LIP-like images) and multiple hilar and mediastinal lymphadenopathy (A-C). The fifth biopsy was tried in his left epitrochlear lymph nodes and the pathological photomicrographs showed marked interfollicular infiltration of plasma cells [D (Hematoxylin and eosin, ×200) and E (CD138 staining, ×200)]. Then he was diagnosed with Castleman disease of plasma cell variant. He and his families refused chemotherapy, but he showed up in the local clinic regularly.