ABSTRACT
<p><b>OBJECTIVE</b>To investigate the cell features of 6 Castleman's disease patients and evaluate their prognosis.</p><p><b>METHODS</b>The resected tumors were investigated by routine histopathology and immunohistochemistry. Reverse-transcript PCR (RT-PCR) and sequencing of RT-PCR products were used to assess the clonal characters of the main tumor cells.</p><p><b>RESULTS</b>Histologically, all of the 6 tumors were classified as the hyaline vascular type. B-cells dominated the follicular germinal centers, with T-cells dispersing inter-follicularly. The results of RT-PCR each obtained a single band of either 128 bp or 122 bp and sequencing showed that there was highly homogeneity within the same length sequences, accompanied by fewer different nucleotide acids.</p><p><b>CONCLUSION</b>Monoclonal and/or oligoclonal B cells were identified in Castleman's disease. These B cells were originated from germinal center cells.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Antigens, CD20 , B-Lymphocytes , Metabolism , Pathology , Castleman Disease , Genetics , Metabolism , Pathology , Clone Cells , Gene Rearrangement, B-Lymphocyte, Heavy Chain , Genetics , Immunohistochemistry , Leukocyte Common Antigens , Prognosis , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
<p><b>OBJECTIVE</b>To study the pathogenesis and the differential diagnosis of Castleman's disease.</p><p><b>METHODS</b>Histopathology, immunohistochemical staining and clinical courses of 26 cases of Castleman's disease (CD) were studied with follow-up study of 16 cases.</p><p><b>RESULTS</b>The present study included 6 cases of multicentric type, 20 cases of localized type in the clinical aspects and 19 cases with hyaline vascular type, 4 cases with plasma cell type, 3 cases with mixed type in the histologic aspect. The Multicentric type presented systemic lymphadenopathy, anemia, hyperglobulinemia, hepatosplenomegaly, skin changes, and lung disorder and kidney disfunction, of which 1 case died of respiratory and renal insufficiency. 13 of the 20 localized cases were of the hyaline vascular type, and with good prognosis. 7 of the 20 cases showed paraneoplastic pemphigus associated with hyperglobulinemia (4/7) and lung disease (5/7). The pathologic features composed of proliferation of the mantle zone B cell, follicular dendritic cell, plasma cell and small vessels. In immunohistochemical staining, kappa and lambda light chains were detected in each CD case.</p><p><b>CONCLUSIONS</b>Many diseases are similar to CD clinicopathologically. It is important to make differential diagnosis through pathological study. Castleman's disease is a lymphoproliferative disorder. The pathogenesis of this multicentric disorder may be associated with autoimmune disease.</p>