Idiopathic multicentric Castleman's disease : a clinicopathologic study in comparison with IgG4-related disease

The present study aimed to compare clinicopathologic features between idiopathic multicentric Castleman's disease (n=22) and IgG4-related disease (n=26). Histology was analyzed using lymph node and lung biopsies. The expression of IL-6 mRNA in tissue was also examined by in situ hybridization and real-time PCR. Patients with idiopathic multicentric Castleman's disease were significantly younger than those with IgG4-related disease (p<0.001). Splenomegaly was observed in only idiopathic multicentric Castleman's disease (p=0.002), while pancreatitis and sialo-dacryoadenitis were restricted to IgG4-related disease (both p<0.001). Serum IgG4 concentrations were commonly elevated at >135 mg/dL in both groups (p=0.270). However, the IgG4/IgG ratio in IgG4-related disease was significantly higher than that in Castleman's disease (p<0.001). Histologically, sheet-like plasmacytosis was highly characteristic of idiopathic multicentric Castleman's disease (p<0.001), while plasmacytic infiltration in IgG4-related disease was always associated with intervening lymphocytes. Similar to laboratory findings, the IgG4/IgG-positive plasma cell ratio, but not the IgG4-positive cell count, was significantly higher in IgG4-related disease (p=0.002). Amyloid-like hyalinized fibrosis was found in 6/8 lung biopsies (75%) of Castleman's disease. The over-expression of IL-6 mRNA was not confirmed in tissue samples of Castleman's disease by either in situ hybridization or quantitative real-time PCR. In conclusion, useful data for a differential diagnosis appear to be age, affected organs, the serum IgG4/IgG ratio, sheet-like plasmacytosis in biopsies, and the IgG4/IgG-positive cell ratio on immunostaining. Since IL-6 was not over-expressed in tissue of idiopathic multicentric Castleman's disease, IL-6 may be produced outside the affected organs, and circulating IL-6 may lead to lymphoplasmacytosis at nodal and extranodal sites.

Medienart:

E-Artikel

Erscheinungsjahr:

2018

Erschienen:

2018

Enthalten in:

Zur Gesamtaufnahme - volume:9

Enthalten in:

Oncotarget - 9(2018), 6 vom: 23. Jan., Seite 6691-6706

Sprache:

Englisch

Beteiligte Personen:

Otani, Kyoko [VerfasserIn]
Inoue, Dai [VerfasserIn]
Fujikura, Kohei [VerfasserIn]
Komori, Takahiro [VerfasserIn]
Abe-Suzuki, Shiho [VerfasserIn]
Tajiri, Takuma [VerfasserIn]
Itoh, Tomoo [VerfasserIn]
Zen, Yoh [VerfasserIn]

Links:

Volltext

Themen:

Autoimmune pancreatitis
Castleman
IL-6
IgG4
Journal Article
Pathology

Anmerkungen:

Date Revised 20.11.2019

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.18632/oncotarget.24068

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM281261881