{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:03:12Z","timestamp":1756339392934,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A 49-year-old man with superficial lymphadenopathy presented with symptoms of low-grade fever, general fatigue and weight loss. On examination, multiple superficial lymphadenopathies and brown macules were observed on the trunk. Laboratory studies revealed an elevation of serum C reactive protein and interleukin 6 (IL-6) in addition to polyclonal hyperimmunoglobulinaemia. High-resolution CT of the chest showed bilateral multiple nodules and patchy ground-glass opacities with interstitial thickening. Biopsy of the cervical lymph node and skin biopsy showed numerous perivascular plasma cells, which were characteristic of the plasma cell type of Castleman's disease. Surgical lung biopsy showed hyalinising granuloma, which are hyalinous nodular lesions surrounded by lymphoid cells. He was diagnosed with multicentric Castleman's disease complicated by pulmonary hyalinising granulomas; his symptoms improved by treatment with tocilizumab, which is a humanised antihuman IL-6 receptor monoclonal antibody and corticosteroid. This is the first report of a comorbid case successfully treated with tocilizumab and corticosteroid.<\/jats:p>","DOI":"10.1136\/bcr-2013-010233","type":"journal-article","created":{"date-parts":[[2013,9,26]],"date-time":"2013-09-26T07:36:33Z","timestamp":1380180993000},"page":"bcr2013010233","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["A comorbid case of multicentric Castleman's disease and pulmonary hyalinising granuloma successfully treated with tocilizumab and corticosteroid"],"prefix":"10.1136","volume":"2013","author":[{"given":"Naoko","family":"Takeuchi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Arai","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Kitaichi","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshikazu","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Diffuse Lung Diseases and Respiratory Failure, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,9,26]]},"reference":[{"key":"2025082701200572000_2013.sep26_1.bcr2013010233.1","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1002\/1097-0142(195607\/08)9:4<822::AID-CNCR2820090430>3.0.CO;2-4","article-title":"Localized mediastinal lymph-node hyperplasia resembling thymoma","volume":"2013","author":"Castleman","year":"1956","journal-title":"Cancer"},{"key":"2025082701200572000_2013.sep26_1.bcr2013010233.2","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1093\/ajcp\/69.1.86","article-title":"Multicentric giant lymph node hyperplasia","volume":"2013","author":"Gaba","year":"1978","journal-title":"Am J Clin Pathol"},{"key":"2025082701200572000_2013.sep26_1.bcr2013010233.3","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1182\/blood.V74.4.1360.1360","article-title":"Pathogenic significance of interleukin-6 (IL-6\/BSF-2) in Castleman's Disease","volume":"2013","author":"Yoshizaki","year":"1989","journal-title":"Blood"},{"key":"2025082701200572000_2013.sep26_1.bcr2013010233.4","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1182\/blood.V95.1.56","article-title":"Improvement in Castleman's disease by humanized anti-interleukin-6 receptor antibody therapy","volume":"2013","author":"Nishimoto","year":"2000","journal-title":"Blood"},{"key":"2025082701200572000_2013.sep26_1.bcr2013010233.5","first-page":"997","article-title":"Pulmonary hyalinizing granuloma","volume":"2013","author":"Engleman","year":"1977","journal-title":"Am Rev Respir Dis"},{"key":"2025082701200572000_2013.sep26_1.bcr2013010233.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ajcp\/87.1.1","article-title":"Pulmonary hyalinizing granuloma","volume":"2013","author":"Yousem","year":"1987","journal-title":"Am J Clin Pathol"},{"key":"2025082701200572000_2013.sep26_1.bcr2013010233.7","doi-asserted-by":"crossref","first-page":"689","DOI":"10.2169\/internalmedicine.33.689","article-title":"Pulmonary hyalinizing granuloma with Castleman's disease","volume":"2013","author":"Atagi","year":"1994","journal-title":"Intern Med"},{"key":"2025082701200572000_2013.sep26_1.bcr2013010233.8","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1002\/1097-0142(197203)29:3<670::AID-CNCR2820290321>3.0.CO;2-#","article-title":"Hyaline-vascular and plasma cell types of giant lymph node hyperplasia of the mediastinum and other locations","volume":"2013","author":"Keller","year":"1972","journal-title":"Cancer"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-010233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:20:14Z","timestamp":1756282814000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-010233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,9,26]]},"references-count":8,"alternative-id":["10.1136\/bcr-2013-010233"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-010233","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2013,9,26]]}}}