• Shino Fujimoto, Tomoyuki Sakai, Hiroshi Kawabata, Nozomu Kurose, Sohsuke Yamada, Mariko Doai, Munetaka Matoba, Haruka Iwao-Kawanami, Takafumi Kawanami, Shuichi Mizuta, Toshihiro Fukushima, Hiroki Mizumaki, Masaki Yamaguchi, and Yasufumi Masaki.
• Department of Hematology and Immunology, Kanazawa Medical University, Japan.
• Intern. Med. 2019 Sep 1; 58 (17): 255525602555-2560.

AbstractA 73-year-old man was referred to our hospital with a persistent fever, anemia, and a mass in the left pubic region. The findings of biopsy evaluations of the mass and a left inguinal lymph node were consistent with Castleman disease (CD) of plasma cell type. His serum interleukin 6 (IL-6) level was remarkably elevated, supporting the diagnosis of CD. However, imaging analyses revealed destruction of the pubic bone by the mass, which was atypical for CD. Therefore, another deeper biopsy was performed, which finally led to the diagnosis of IL-6-producing osteosarcoma. We conclude that clinicians should carefully exclude malignancies prior to making a CD diagnosis.

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