Kojima Masaru, Nakamura Shigeo, Miyawaki Shuuichi, Ohno Yoshihiro, Sakata Noriyuki, Masawa Nobuhide
Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, Japan.
APMIS. 2005 Apr;113(4):288-95. doi: 10.1111/j.1600-0463.2005.apm_08.x.
We report three cases showing progressive transformation of the germinal center (PTGC) with histological features reminiscent of the hyaline-vascular (HV) variant of Castleman's disease (CD). Each case contained a few small HV germinal centers as well as PTGC and hyperplastic germinal centers with or without follicular lysis. Moreover, some of the PTGC were penetrated by hyalinized small vessels. Our three cases also showed some of the characteristic histological findings of HV type of CD: (i) reactive lymphoid follicles with small hyaline-vascular germinal centers surrounded by small lymphocytes in a concentrated fashion; (ii) a few small foci of plasmacytoid monocytes; (iii) perivascular fibrosis; (iv) interfollicular vascularity; (v) tight/concentric pattern of the follicular dendritic cell network; and (vi) absence of CD57+ T-cells in the HV follicles. The PTGC with coexistent HV type of CD may represent a certain form of reactive follicular hyperplasia. The possibility of PTGC should be considered and excluded before diagnosing CD.
我们报告了3例显示生发中心进行性转化（PTGC）的病例，其组织学特征让人联想到Castleman病（CD）的透明血管（HV）型。每个病例都包含一些小的HV生发中心以及PTGC和增生性生发中心，伴有或不伴有滤泡溶解。此外，一些PTGC被透明化的小血管穿透。我们的3例病例还显示了HV型CD的一些特征性组织学表现：（i）反应性淋巴滤泡，小的透明血管生发中心被小淋巴细胞以集中的方式包围；（ii）少数小灶性浆细胞样单核细胞；（iii）血管周围纤维化；（iv）滤泡间血管形成；（v）滤泡树突状细胞网络的紧密/同心模式；以及（vi）HV滤泡中不存在CD57+T细胞。伴有共存HV型CD的PTGC可能代表某种形式的反应性滤泡增生。在诊断CD之前，应考虑并排除PTGC的可能性。
