Monoclonality and polyclonality of plasma cells in Castleman's disease of the plasma cell variant

Histopathology. 1989 Jan;14(1):11-24. doi: 10.1111/j.1365-2559.1989.tb02110.x.

Abstract

Castleman's disease of the plasma cell variant observed in 21 patients was investigated morphologically and by immunohistochemistry. The male to female ratio was 2.5:1. The age ranged from 18 to 71 years (mean age 47.6 years). Histologically, the lesions were characterized by numerous, evenly distributed germinal centres ranging from large hyperplastic to small hyaline-vascular types with moderate to extensive sheets of plasma cells in between. In all cases with generalized lymph node enlargement dilated sinuses could be found. Immunohistochemical studies demonstrated a polyclonal plasma cell population in 11 of 18 lesions. Seven lesions contained a monoclonal plasma cell population, five with IgG/lambda and two with IgA/lambda; clinically, two of these patients had generalized lymphadenopathy; in none could manifestation of a plasmacytoma be found outside the lymph node lesion; only two of the seven patients exhibited a paraproteinaemia (IgG/lambda and IgA/lambda, respectively) corresponding to the Ig type of the proliferated plasma cells. Six patients with polyclonal lesions had constitutional symptoms such as fever, anaemia, polyclonal hypergammaglobulinaemia; one of these six patients manifested symptoms consistent with a diagnosis of Takatsuki syndrome. The monoclonal plasma cell type of Castleman's disease did not progress to a generalized disease. This monoclonal variant may be a lymph nodebased type of benign monoclonal gammopathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Castleman Disease / immunology*
  • Castleman Disease / pathology
  • Female
  • Humans
  • Immunoglobulin A / analysis
  • Immunoglobulin G / analysis
  • Immunoglobulin M / analysis
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Plasma Cells / immunology*
  • Plasma Cells / pathology

Substances

  • Immunoglobulin A
  • Immunoglobulin G
  • Immunoglobulin M