48,847
edits
Difference between revisions of "Castleman disease"
Jump to navigation
Jump to search
split out
(redirect) |
(split out) |
||
| Line 1: | Line 1: | ||
'''Castleman disease''', abbreviated '''CD''', is a rare [[Lymph node pathology|pathology of the lymph node]]. | |||
It is also known as '''angiofollicular lymph node hyperplasia''' and '''giant lymph node hyperplasia'''.<ref>URL: [http://www.mayoclinic.com/health/castleman-disease/DS01000 http://www.mayoclinic.com/health/castleman-disease/DS01000]. Accessed on: 17 June 2010.</ref> | |||
==General== | |||
*Benign. | |||
*Hyaline vascular variant - a pathology of the follicular dendritic cells.<ref>{{Cite journal | last1 = Cokelaere | first1 = K. | last2 = Debiec-Rychter | first2 = M. | last3 = De Wolf-Peeters | first3 = C. | last4 = Hagemeijer | first4 = A. | last5 = Sciot | first5 = R. | title = Hyaline vascular Castleman's disease with HMGIC rearrangement in follicular dendritic cells: molecular evidence of mesenchymal tumorigenesis. | journal = Am J Surg Pathol | volume = 26 | issue = 5 | pages = 662-9 | month = May | year = 2002 | doi = | PMID = 11979097 }}</ref> | |||
===Classification=== | |||
CD is grouped by histologic appearance:<ref name=Ref_ILNP228>{{Ref ILNP|228}}</ref> | |||
#Hyaline vascular (HV) variant (described by Castleman). | |||
#*Usually unicentric. | |||
#*Typically mediastinal or axial. | |||
#*More common than plasma cell variant; represents 80-90% of CD cases. | |||
#*May be associated with [[follicular dendritic cell neoplasia]].<ref name=Ref_WMSP_596>{{Ref WMSP|596}}</ref> | |||
#Plasma cell (PC) variant. | |||
#*Usually multicentric, may be unicentric. | |||
#*Abundant plasma cells. | |||
#*Associated with [[HHV-8]] infection (the same virus implicated in ''Kaposi's sarcoma''). | |||
Notes: | |||
*The subclassification of CD is in some flux. Some authors advocate splitting-out ''HHV-8'' and ''multicentric'' as separate subtypes.<ref name=pmid19546611>{{Cite journal | last1 = Cronin | first1 = DM. | last2 = Warnke | first2 = RA. | title = Castleman disease: an update on classification and the spectrum of associated lesions. | journal = Adv Anat Pathol | volume = 16 | issue = 4 | pages = 236-46 | month = Jul | year = 2009 | doi = 10.1097/PAP.0b013e3181a9d4d3 | PMID = 19546611 }}</ref> | |||
==Microscopic== | |||
===Hyaline-vascular variant=== | |||
Features:<ref>URL: [http://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_9_number_2_11/article/a_rare_case_of_castleman_s_disease_presenting_as_cervical_neck_mass.html http://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_9_number_2_11/article/a_rare_case_of_castleman_s_disease_presenting_as_cervical_neck_mass.html]. Accessed on: 15 June 2010.</ref><ref name=Ref_ILNP236>{{Ref ILNP|236}}</ref> | |||
*Pale concentric (expanded) mantle zone lymphocytes - '''key feature'''. | |||
**"Regressed follicles" - germinal center (pale area) is small. | |||
*"Lollipops": | |||
**Germinal centers fed by prominent (radially penetrating sclerotic) vessels; lollipop-like appearance. | |||
*Two germinal centers in one follicle. | |||
*Hyaline material (pink acellular stuff on H&E) in germinal center. | |||
*Sinuses effaced (lost). | |||
*Mitoses absent. | |||
====Images==== | |||
<gallery> | |||
Image:Castleman_disease_-_high_mag.jpg | CD HVV - "lollipop" sign - high mag. (WC) | |||
Image:Castleman_disease_-_intermed_mag.jpg | CD HVV - showing expanded mantle zone - intermed. mag. (WC) | |||
</gallery> | |||
www: | |||
*[http://path.upmc.edu/cases/case115.html CD HVV - case 1 - several images (upmc.edu)]. | |||
*[http://path.upmc.edu/cases/case301.html CD HVV - case 2 - several images (upmc.edu)]. | |||
===Plasma cell variant=== | |||
Features:<ref name=Ref_ILNP236>{{Ref ILNP|236}}</ref> | |||
*Interfollicular sheets of plasma cells - '''key feature'''. | |||
*Active germinal centers - mitoses present. | |||
*Sinus perserved. | |||
==IHC== | |||
Hyaline-vascular variant: | |||
*Stains to exclude [[mantle cell lymphoma]]: | |||
**Cyclin D1. | |||
Plasma cell variant: | |||
*HHV-8 +ve. | |||
==See also== | |||
*[[Lymph node pathology]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | |||
[[Category:Lymph node pathology]] | |||