Clinical Implication of Idiopathic Plasmacytic Lymphadenopathy with Polyclonal Hypergammaglobulinemia: A Report of 16 Cases

Idiopathic plasmacytic lymphadenopathy (IPL) with polyclonal hyperimmunoglobulinemia is considered identical to multicentric Castleman's disease (MCD) reported in western countries. Clinically, both IPL and MCD are characterized by multicentric lymphadenopathy, prominent polyclonal hypergammagl...

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Veröffentlicht in:International journal of surgical pathology 2004-01, Vol.12 (1), p.25-30
Hauptverfasser: Kojima, Masaru, Nakamura, Shigeo, Shimizu, Kazuhiko, Itoh, Hideaki, Yamane, Yuko, Murayama, Kayoko, Tanaka, Hiroshi, Sugihara, Shiro, Shimano, Shunichi, Sakata, Noriyuki, Masawa, Nobuhide
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container_title International journal of surgical pathology
container_volume 12
creator Kojima, Masaru
Nakamura, Shigeo
Shimizu, Kazuhiko
Itoh, Hideaki
Yamane, Yuko
Murayama, Kayoko
Tanaka, Hiroshi
Sugihara, Shiro
Shimano, Shunichi
Sakata, Noriyuki
Masawa, Nobuhide
description Idiopathic plasmacytic lymphadenopathy (IPL) with polyclonal hyperimmunoglobulinemia is considered identical to multicentric Castleman's disease (MCD) reported in western countries. Clinically, both IPL and MCD are characterized by multicentric lymphadenopathy, prominent polyclonal hypergammaglobulinemia, elevated erythrocyte sedimentation rate, elevated serum interleukin-6 concentration, bone marrow plasmacytosis, and various abnormal laboratory data such as anemia and positive autoantibodies. However, IPL has a significantly better 5-year survival rate than that of MCD. Moreover, none of the present 16 cases developed Kaposi's sarcoma or B-cell lymphoma. Histologically, the interfollicular area contains a sheet of polytypic mature plasma cells in both IPL and MCD. In MCD, the majority of lymphoid follicles had hyaline-vascular germinal centers. However, lymphoid follicles of IPL usually exhibit a hyperplastic germinal center. Immunostaining also demonstrated a normal/ reactive follicular dendritic cell network pattern in the germinal center of IPL. Moreover, there were no human herpes virus-8-positive cells detected by immunohistochemistry. The overall clinicopathologic and immunohistochemical findings of our 16 cases suggest that IPL is distinct from MCD reported in Western countries.
doi_str_mv 10.1177/106689690401200104
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subjects Adult
Aged
Castleman Disease - mortality
Castleman Disease - pathology
Castleman Disease - virology
Diagnosis, Differential
Female
Herpesvirus 4, Human - isolation & purification
Humans
Hypergammaglobulinemia - mortality
Hypergammaglobulinemia - pathology
Hypergammaglobulinemia - virology
Immunohistochemistry
In Situ Hybridization
Lymphatic Diseases - mortality
Lymphatic Diseases - pathology
Lymphatic Diseases - virology
Male
Middle Aged
Plasma Cells - pathology
title Clinical Implication of Idiopathic Plasmacytic Lymphadenopathy with Polyclonal Hypergammaglobulinemia: A Report of 16 Cases
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