Guess the Diagnosis: Case 1 - Episode 9
What is the most likely diagnosis for this patient?
Frits van Rhee, MD, PhD, University of Arkansas for Medical Sciences, says that in order to make a diagnosis of multicentric Castleman’s disease, one must have the correct pathology in the correct context, so the symptoms are compatible with the disease. Then, one must exclude the other disorders, which is very important. The next step is to be sure that there are lymph nodes present in more than one area, such as the armpits, chest, belly, or in the groins. In order to diagnose what is called multicentric Castleman’s disease, one must have lymph nodes in multiple areas. Lastly, it’s crucial to make a distinction as to whether or not the disease is driven by a virus. There’s a virus called Human Herpesvirus type 8, which can actively replicate and cause a very similar picture. This is referred to as HHV8 associated multicentric Castleman’s disease. If this virus is not present and not actively replicating and dividing in the bloodstream for patients, it is called idiopathic multicentric Castleman’s disease. The distinction is really important because the treatment is very different.
Guess the Diagnosis: Case 1
Lisa B. is a 47-year-old female store owner from St. Louis, with a 10-month history of fatigue, night sweats, and weight loss.
Lisa’s pathology report shows the following findings:
In view of these findings, the hematologist orders further tests, which yield the following results: