{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T12:51:08Z","timestamp":1775479868309,"version":"3.50.1"},"reference-count":14,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:00:00Z","timestamp":1679356800000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,3,9]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>A woman in her 60s with suspected multicentric Castleman\u2019s disease, who was receiving treatment with oral prednisolone, presented to our hospital with mild cough and malaise. Chest CT showed diffuse infiltrative and granular shadows, indicating exacerbation of lung lesions caused by steroid-resistant multicentric Castleman\u2019s disease. A video-assisted thoracoscopic lung and mediastinal lymph node biopsy was performed. The biopsy revealed mediastinal lymph node tissue consistent with multicentric Castleman\u2019s disease, as well as presence of <jats:italic>Cryptococcus neoformans<\/jats:italic> in the alveolar space. <jats:italic>C. neoformans<\/jats:italic> infection in immunocompromised individuals may present with diffuse lung lesions and should be noted as a mimicker of acute exacerbation of Castleman\u2019s disease.<\/jats:p>","DOI":"10.1136\/bcr-2022-252595","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T01:05:35Z","timestamp":1679879135000},"page":"e252595","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Diffuse cryptococcal pneumonia in multicentric Castleman\u2019s disease with elevated serum IgG<sub>4<\/sub>"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1690-9801","authenticated-orcid":false,"given":"Junji","family":"Takiguchi","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Kobe City Medical Center West Hospital, Kobe, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromi","family":"Tomioka","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Kobe City Medical Center West Hospital, Kobe, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6067-9049","authenticated-orcid":false,"given":"Katsuhiko","family":"Kamei","sequence":"additional","affiliation":[{"name":"Medical Mycology Research Center, Chiba University, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinori","family":"Kawabata","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Pathology, Local Incorporated Administrative Agency Saitama Prefectural Hospital Organization Saitama Cardiovascular and Respiratory Center, Kumagaya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,3,21]]},"reference":[{"key":"2025082708423012000_16.3.e252595.1","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\u2019s disease","volume":"74","author":"Yoshizaki","year":"1989","journal-title":"Blood"},{"key":"2025082708423012000_16.3.e252595.2","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2009.17"},{"key":"2025082708423012000_16.3.e252595.3","doi-asserted-by":"crossref","DOI":"10.12659\/AJCR.926433","article-title":"A fatal case of Kaposi sarcoma immune reconstitution syndrome (KS-IRIS) complicated by Kaposi sarcoma Inflammatory Cytokine Syndrome (KICS) or multicentric Castleman disease (MCD): a case report and review","volume":"21","author":"Dumic","year":"2020","journal-title":"Am J Case Rep"},{"key":"2025082708423012000_16.3.e252595.4","doi-asserted-by":"publisher","DOI":"10.1086\/654798"},{"key":"2025082708423012000_16.3.e252595.5","doi-asserted-by":"crossref","first-page":"253","DOI":"10.5045\/br.2014.49.4.253","article-title":"Clinical features and outcomes in patients with human immunodeficiency virus-negative, multicentric Castleman\u2019s disease: a single medical center experience","volume":"49","author":"Seo","year":"2014","journal-title":"Blood Res"},{"key":"2025082708423012000_16.3.e252595.6","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318157c068"},{"key":"2025082708423012000_16.3.e252595.7","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2010.082958"},{"key":"2025082708423012000_16.3.e252595.8","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2017-000432","article-title":"Distinct features distinguishing IgG4-related disease from multicentric Castleman\u2019s disease","volume":"3","author":"Sasaki","year":"2017","journal-title":"RMD Open"},{"key":"2025082708423012000_16.3.e252595.9","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jiac.2014.08.025","article-title":"Clinical features of pulmonary cryptococcosis in non-HIV patients in japan","volume":"21","author":"Kohno","year":"2015","journal-title":"J Infect Chemother"},{"key":"2025082708423012000_16.3.e252595.10","doi-asserted-by":"publisher","DOI":"10.1038\/srep23002"},{"key":"2025082708423012000_16.3.e252595.11","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jiac.2017.09.009","article-title":"Disseminated cryptococcosis in a patient taking tocilizumab for Castleman\u2019s disease","volume":"24","author":"Nishioka","year":"2018","journal-title":"J Infect Chemother"},{"key":"2025082708423012000_16.3.e252595.12","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1093\/mmy\/myy086","article-title":"Pulmonary cryptococcosis: a review of pathobiology and clinical aspects","volume":"57","author":"Setianingrum","year":"2019","journal-title":"Med Mycol"},{"key":"2025082708423012000_16.3.e252595.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2005.09.017"},{"key":"2025082708423012000_16.3.e252595.14","doi-asserted-by":"crossref","DOI":"10.1371\/journal.ppat.1009342","article-title":"The granuloma in cryptococcal disease","volume":"17","author":"Ristow","year":"2021","journal-title":"PLoS Pathog"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-252595","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:42:40Z","timestamp":1756309360000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-252595"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":14,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3,21]]},"published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1136\/bcr-2022-252595"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-252595","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}