Idiopathic multicentric Castleman disease: a mysterious case of generalized lymphadenopathy

Castleman disease is a syndrome with significant clinico-pathological overlap between malignancy, autoimmune causes and infectious etiologies. It spectrum can vary in extent from unicentric to multicentric generalized lymphadenopathy, organ involvement, constitutional symptoms cytopenias, severity non-severe severe TAFRO symptoms. Idiopathic (iMCD) diagnosis of exclusion after multiple as per diagnostic criteria are excluded. Treatment varies the types anti-IL 6 antibodies for cytotoxic chemotherapy agents We hereby report case type iMCD prolonged course delayed arrival at diagnosis, owing rarity this condition, which stresses need reduced threshold consider MCD, early differential diagnosis. Interestingly there were positive auto-antibodies elevated IgG4 levels patient, but applying strict helps distinguish