Hyaline-vascular type of Castleman's disease (angiofollicular lymph node hyperplasia) with monotypic plasma cells. An immunohistochemical study with monoclonal antibodies

Abstract

A case of angiofollicular lymph node hyperplasia (Castleman's disease) characterized by nionotypic (1gG + , 1arnbda-t) plasrnacytosis is described. I'resh tissue was available and a thorough iiiiunohistocheniical analysis of lymphoid and noiilyniphoid cells was performed on cryostat sections. Although lyrnphoid follicles were nurnerous and exhibited sonie abnormal features they did not appear part of the nionocloiial cell proliferatiun. Follicular lymphocytes were niixtures of Kappai and 1arnbda-t cells. Vessels penetrating within these abnormal follicles expressed reduced levels of FVlll and Leu-M5 antigens and exhibited thicker layer oí collagen type IV. The analysis of T-cell subsets showed a normal (3:l) T4/T8 ratio. This case extends to the mixed variant of hyaline-vascular Castleman's disease, the neoplastic potential previously associated to the plasrria cell variant of the disease.