PMC2825517_01
Multi-detector computed tomography (CT) thorax and abdomen with intravenous contrast enhancement showing hepatosplenomegaly, axillary and abdominal lymphadenopathy.
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F1
A CT scan showed hepato-splenomegaly and gross lymphadenopathy involving the thorax, abdomen and pelvis (Figure 1).
Inguinal lymph node biopsy: histology characteristic of MCD: (A) Haematoxylin & Eosin stained section of lymph node (original magnification x 2.5) showing effaced architecture with few residual follicles. (B) infiltration with large blastic cells (PB, original magnification x 60). (C) Immunostaining reveals blastic cells express HHV-8 (positive cells are brown, original magnification x 60).
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F2
Inguinal lymph node excision biopsy confirmed the clinical suspicion of Multi-centric Castleman's disease (MCD) (Figure 2).
Chest X-ray showing bilateral diffuse infiltrates.
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F3
The chest radiograph progressed over four days to bilateral diffuse patchy consolidation (Figure 3), associated with greatly increased oxygen requirements (FiO2 0.8), and consistent with a diagnosis of acute respiratory distress syndrome (ARDS).