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Clinical Implications of Idiopathic Multicentric Castleman Disease Among Japanese: A Report of 28 Cases

Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, mkojima{at}gunma-cc.jp

Naoya Nakamura, MD

Department of Pathology, Tokai University School of Medicine, Isehara

Norihumi Tsukamoto, MD

Department of Medicine and Clinical Science, Gunma University School of Medicine, Maebashi

Yoshiro Otuski, MD

Department of Pathology, Hamamatsu Seirei Hospital, Hamamatsu

Kazuhiko Shimizu, MD

Department of Pathology and Clinical Laboratories, Ashikaga Red Cross Hospital, Ashikaga

Hideaki Itoh, MD

Department of Pathology and Clinical Laboratories, Maebashi Red Cross Hospital, Maebashi

Satsuki Kobayashi, MD

Department of Internal Medicine, Toho Hospital, Midori

Hiroshi Kobayashi, MD

Department of Pathology, Hamamatsu Seirei Hospital, Hamamatsu

Takuhei Murase, MD

Department of Hematology, Nishio City Hospital, Nishio

Nobuhide Masawa, MD

Department of Diagnostic and Anatomic Pathology, Dokkyo Medical University School of Medicine, Mibu

Makoto Kashimura, MD

Department of Hematology, Matsudo City Hospital, Matsudo

Shigeo Nakamura, MD

Department of Pathology and Clinical Laboratories, Nagoya University School of Medicine, Nagoya Japan

To clarify the clinicopathologic findings of idiopathic multicentric Castleman disease among Japanese, 28 cases were studied. Two variants were delineated by the clinicopathologic findings (1) idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia (n = 18) and (2) nonidiopathic plasmacytic lymphadenopathy type (n= 10). Clinicopathologically, idiopathic plasmacytic lymphadenopathy was defined by the prominent polyclonal hyperimmunoglobulinemia, normal germinal centers, and sheet-like infiltration of plasma cells in the interfollicular area of the lymph node. Histologically, the nonidiopathic plasmacytic lymphadenopathy type was characterized by hyaline-vascular germinal centers of the lymph node lesion. In comparison with idiopathic plasmacytic lymphadenopathy, patients with nonidiopathic plasmacytic lymphadenopathy showed infrequent prominent polyclonal hyperimmunoglobulinemia and frequent association with autoimmune disease. However, there was no difference in the overall 5-year survival between the 2 subtypes. Compared with idiopathic multicentric Castleman disease in Western countries, the chronic course of the disease of idiopathic multicentric Castleman disease in Japan appears to be related to negativity for human herpesvirus 8 infection.

Key Words: multicentric Castleman disease • lymph node • clinicopathological study • idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia • autoimmune disease

This version was published on October 1, 2008

International Journal of Surgical Pathology, Vol. 16, No. 4, 391-398 (2008)
DOI: 10.1177/1066896908315812


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