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plasmocytic Castleman disease

Wednesday 6 January 2010

plasma cell type of Castleman disease; plasma cell variant

Digital case

 HPC:335 : Plasmocytic Castleman disease (associated to Kaposi sarcoma)

Images

 https://twitter.com/KyleBradleyMD/status/732318591555645440

Synopsis

 diffuse plasma cell proliferation in interfollicular tissue
 follicular hyperplasia without vascular hyaline changes
 interfollicular region showing a massive infiltration by plasma cells. Some of these plasma cells show multinucleation and mild nuclear atypia.
 Sometimes numerous Russell bodies
 Hyaline-vascular changes in follicles inconspicuous or absent
 Often deposition of an amorphous acidophilic material that probably contains fibrin and immune complexes in center of follicles
 Overall appearance reminiscent of that in lymph nodes in rheumatoid arthritis

Association

 HHV8-associated Kaposi sarcoma

Physiopathology

 Abundant expression of interleukin-6: thought to be responsible for plasma cell infiltration.

Differential diagnosis

 Idiopathic plasmacytic lymphadenopathy with polyclonal hypergammaglobulinemia:
 Oriental disease closely related to plasma cell type, but apparently not identical.

See also

 Castleman disease

References

 Multicentric Castleman disease in an HHV-8-infected child born to consanguineous parents. Leroy S, Moshous D, Cassar O, Reguerre Y, Byun M, Pedergnana V, Canioni D, Gessain A, Oksenhendler E, Fieschi C, Mahlaoui N, Rivière JP, Herbigneaux RM, Muszlak M, Arnaud JP, Fischer A, Picard C, Blanche S, Plancoulaine S, Casanova JL. Pediatrics. 2012 Jan;129(1):e199-203. PMID: 22157133