Kaposi Sarcoma and HHV-8-Associated Multicentric Castleman Disease: A Case Report

Background. Multicentric Castleman disease (MCD) is a rare lymphoproliferative disorder characterized by generalized lymphadenopathy, systemic inflammatory symptoms, and distinctive histopathologic findings. HHV-8-associated MCD is typically observed in patients with human immunodeficiency virus (HIV) infection or other states of profound immunosuppression. In contrast, HHV-8-associated disease in immunocompetent individuals is uncommon and associated with higher mortality rates. Case. This is a case of a patient who presented with progressive fatigue, weakness, anorexia, and a chronic cough for four months following a trip to Mexico. Initial workup revealed anemia and thrombocytopenia, negative HIV status, and prominent bilateral axillary and mediastinal lymphadenopathy, which was later confirmed by pathology to represent HHV-8-associated multicentric Castleman disease (MCD) with concurrent Kaposi sarcoma. Conclusion. We highlight an unusual presentation of HHV-8-associated MCD in an immunocompetent patient, illustrating the different clinical courses for HIV positive HHV-8-associated MCD compared with HIV negative HHV-8-associated MCD, and emphasize the essential role of pathology in certain infectious disease diagnoses.