Diagnostic delay and histopathological subtyping challenges in idiopathic multicentric Castleman disease, not otherwise specified: a case report of a three-hospital odyssey - Takeaways - MDSpire

Challenges in Diagnosis and Histopathological Classification of Idiopathic Multicentric Castleman Disease: A Case Study Involving Multiple Healthcare Facilities

  • By

  • Fen Zhang

  • Nan Wang

  • Ying-yu Wang

  • Ye Peng

  • Yan-chen Bao

  • Hua-zheng Shi

  • Qian-wen Xiao

  • Xiao-li Zhang

  • Xiao-xi Wang

  • Chun-mei Liao

  • Jing Pan

  • Wei-qiang Teng

  • July 20, 2026

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  • 1

    Castleman disease (CD) is a rare lymphoproliferative disorder with diagnostic challenges due to its heterogeneous nature and nonspecific clinical manifestations.

  • 2

    A 53-year-old male presented with persistent lymphadenopathy and systemic symptoms, leading to a diagnosis of idiopathic multicentric Castleman disease-not otherwise specified (iMCD-NOS).

  • 3

    Histopathological examination revealed disrupted lymph node architecture and mixed-type Castleman disease, emphasizing the importance of excisional biopsy for accurate diagnosis.

  • 4

    The case highlights the necessity of systematically excluding HHV-8 infection and other mimickers to achieve proper subtyping of iMCD-NOS.

  • 5

    The patient's treatment with siltuximab and prednisone resulted in significant symptom improvement, demonstrating the potential effectiveness of targeted therapy.

Original Source(s)

Diagnostic delay and histopathological subtyping challenges in idiopathic multicentric Castleman disease, not otherwise specified: a case report of a three-hospital odyssey

  • by Fen Zhang, Nan Wang, Ying-yu Wang, Ye Peng, Yan-chen Bao, Hua-zheng Shi, Qian-wen Xiao, Xiao-li Zhang, Xiao-xi Wang, Chun-mei Liao, Jing Pan, Wei-qiang Teng

  • July 20, 2026

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