{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:16Z","timestamp":1756339516939,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,16]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Castleman\u2019s disease (CD), also called angiofollicular lymphoid hyperplasia, is a rare lymphoproliferative illness with two unique variants: unicentric disease and multicentric disease (MCD). The multicentric variant is rare and presents as a systemic illness with symptoms like peripheral lymphadenopathy, splenomegaly, anaemia and systemic inflammatory symptoms. Given the vague and systemic presentation, this variant can be difficult to differentiate from infection and other autoimmune diseases. Here, we discuss the case of a middle-aged female who presented to the hospital with a 2\u2009week history of systemic symptoms, including cough, fever, weight loss and painful lymphadenopathy at the neck and posterior auricular region. Initially, the patient was treated for presumed upper respiratory infection in the setting of Epstein\u2013Barr virus (EBV); however, an excisional biopsy of the cervical lymph node confirmed the diagnosis of MCD. In this case, we highlight the diagnostic dilemma of MCD, especially in association with EBV.<\/jats:p>","DOI":"10.1136\/bcr-2024-260775","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T11:55:15Z","timestamp":1738065315000},"page":"e260775","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Epstein\u2013Barr virus associated multicentric Castleman\u2019s disease disguised as infectious mononucleosis"],"prefix":"10.1136","volume":"18","author":[{"given":"Sai Priya","family":"Maddury","sequence":"first","affiliation":[{"name":"Internal Medicine, UCSF Fresno, Fresno, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nidaa","family":"Rasheed","sequence":"additional","affiliation":[{"name":"Internal Medicine, UCSF Fresno, Fresno, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srikar","family":"Sama","sequence":"additional","affiliation":[{"name":"Internal Medicine, UCSF Fresno, Fresno, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pooja","family":"Redyy","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, US Department of Veterans Affairs, Fresno, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"key":"2025082708525769000_18.1.e260775.1","doi-asserted-by":"crossref","first-page":"xiii","DOI":"10.1016\/j.hoc.2017.10.001","article-title":"Castleman Disease","volume":"32","author":"van Rhee","year":"2018","journal-title":"Hematol Oncol Clin North Am"},{"key":"2025082708525769000_18.1.e260775.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2017.09.004"},{"key":"2025082708525769000_18.1.e260775.3","first-page":"314","article-title":"A Rare Lymphoproliferative Disease: Castleman Disease","volume":"38","author":"G\u00fcnd\u00fcz","year":"2021","journal-title":"Turk J Haematol"},{"key":"2025082708525769000_18.1.e260775.4","doi-asserted-by":"publisher","DOI":"10.1097\/PAP.0b013e3181a9d4d3"},{"key":"2025082708525769000_18.1.e260775.5","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1097\/00019606-199300020-00009","article-title":"Disseminated persistent lymphoid hyperplasia containing Epstein-Barr virus and clonal rearrangements of DNA","volume":"2","author":"Samoszuk","year":"1993","journal-title":"Diagn Mol Pathol"},{"key":"2025082708525769000_18.1.e260775.6","first-page":"84","article-title":"Clonal rearrangement for immunoglobulin and T-cell receptor genes in systemic Castleman\u2019s disease. Association with Epstein-Barr virus","volume":"131","author":"Hanson","year":"1988","journal-title":"Am J Pathol"},{"key":"2025082708525769000_18.1.e260775.7","doi-asserted-by":"crossref","DOI":"10.3390\/ijms23020809","article-title":"Epstein-Barr Virus Promotes the Production of Inflammatory Cytokines in Gingival Fibroblasts and RANKL-Induced Osteoclast Differentiation in RAW264.7 Cells","volume":"23","author":"Yokoe","year":"2022","journal-title":"Int J Mol Sci"},{"key":"2025082708525769000_18.1.e260775.8","first-page":"100","article-title":"Epstein-Barr virus-immortalized B cells produce IL-6 as an autocrine growth factor","volume":"70","author":"Yokoi","year":"1990","journal-title":"Immunology"},{"key":"2025082708525769000_18.1.e260775.9","doi-asserted-by":"publisher","DOI":"10.5045\/kjh.2012.47.3.163"},{"key":"2025082708525769000_18.1.e260775.10","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.hoc.2017.09.005","article-title":"Diagnosis of Castleman Disease","volume":"32","author":"Szalat","year":"2018","journal-title":"Hematol Oncol Clin North Am"},{"key":"2025082708525769000_18.1.e260775.11","first-page":"379","article-title":"Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytes: a clinicopathological study","volume":"35","author":"Kikuchi","year":"1972","journal-title":"Nippon Ketsueki Gakkai Zasshi"},{"key":"2025082708525769000_18.1.e260775.12","first-page":"920","article-title":"Cervical subacute necrotizing lymphadenitis","volume":"30","author":"Fujimoto","year":"1972","journal-title":"Naika"},{"key":"2025082708525769000_18.1.e260775.13","doi-asserted-by":"publisher","DOI":"10.1172\/JCI114749"},{"key":"2025082708525769000_18.1.e260775.14","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.semarthrit.2017.01.011","article-title":"Clinical association between Kikuchi\u05f3s disease and systemic lupus erythematosus: A systematic literature review","volume":"47","author":"Sope\u00f1a","year":"2017","journal-title":"Semin Arthritis Rheum"},{"key":"2025082708525769000_18.1.e260775.15","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1200\/JCO.1985.3.9.1202","article-title":"A systemic lymphoproliferative disorder with morphologic features of Castleman\u2019s disease: clinical findings and clinicopathologic correlations in 15 patients","volume":"3","author":"Frizzera","year":"1985","journal-title":"J Clin Oncol"},{"key":"2025082708525769000_18.1.e260775.16","doi-asserted-by":"publisher","DOI":"10.1002\/path.1711440208"},{"key":"2025082708525769000_18.1.e260775.17","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.27.2377"},{"key":"2025082708525769000_18.1.e260775.18","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197203)29:3<670::AID-CNCR2820290321>3.0.CO;2-#"},{"key":"2025082708525769000_18.1.e260775.19","unstructured":"Golfeyz S , Wang A , Chernyavsky S . A rare disease masked by a common etiology: Castleman\u2019s disease disguised as mononucleosis. Abstract published at hospital medicine. 2017."},{"key":"2025082708525769000_18.1.e260775.20","doi-asserted-by":"crossref","DOI":"10.1186\/1749-8090-4-31","article-title":"Possible roles of Epstein-Barr virus in Castleman disease","volume":"4","author":"Chen","year":"2009","journal-title":"J Cardiothorac Surg"},{"key":"2025082708525769000_18.1.e260775.21","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.amjoto.2012.12.003","article-title":"A unique presentation of Epstein-Barr virus-associated Castleman\u2019s disease","volume":"34","author":"Gomes","year":"2013","journal-title":"Am J Otolaryngol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-260775","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:53:04Z","timestamp":1756309984000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-260775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,28]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-260775"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-260775","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}