Osteosarcoma Manifesting Systemic Inflammation and Histological Features Mimicking Plasma Cell-type Castleman Disease

Abstract

A 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.

Castleman disease and TAFRO syndrome

“…Furthermore, patients with lymphomas, such as angioimmunoblastic T cell lymphoma and intravascular large B cell lymphoma [ 21 ], accompanied by hyper-cytokinemia and generalized inflammation, may have MCD-like clinical symptoms and satellite lymph node biopsies may yield MCD-like histopathological findings. Symptoms and histopathology may be similar in patients with cytokine-producing cancers and sarcomas [ 22 ]; various collagen vascular diseases, such as systemic lupus erythematosus, Sjögren’s syndrome [ 23 ], and vasculitis syndrome; and various infections accompanied by hyper-inflammation. Careful diagnosis of iMCD requires the differential diagnoses of these conditions.…”

Interleukin-6-producing Intravascular Large B-cell Lymphoma with Lymphadenopathy Mimicking the Histology of Multicentric Castleman Disease

“…There are several reports regarding a high IL-6 plasma level in tumors (14,16,19,20), hemophagocytic syndrome ( 21 , 22 ), and IVLBCL ( 11 , 23 ) or IL-6 positivity on immunohistochemistry staining ( 14 , 16 , 19 , 20 , 24 ). These cases also support the possibility that paraneoplastically produced IL-6 can induce an MCD-like clinical presentation.…”

Fractional‐Harris hawks optimization‐based generative adversarial network for osteosarcoma detection using Renyi entropy‐hybrid fusion

“…The detection performance was not effective. Shino Fujimoto et al 16 introduced a histological feature for finding the cell type of osteosarcoma. Here, the morphology was dependable with the osteosarcoma diagnosis.…”

“…Obtained a better capacity for migration and proliferation Novel strategies against osteosarcoma were not considered for better detection Shino Fujimoto et al 16…”

“…14,15 However, the analysis of such tumors with the radiological and clinical ground is made based on the histological confirmation of the biopsy specimen. Most of the tumor study relies on the Hematoxylin and Eosin (H&E) images 16 such that it pigments the nuclei as blue while the background tissue is marked as pink in the histology slide. 17 Recently, pathologists manually evaluate the slides using a microscope to analyze the degree of the tumor and the tumor necrosis.…”