Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA.
Am J Clin Pathol. 2013 May;139(5):651-61. doi: 10.1309/AJCPKGF7U8AWQBVG.
Kaposi sarcoma herpesvirus (KSHV), also known as human herpesvirus-8, is associated with 1 form of multicentric Castleman disease (MCD) and is the etiologic agent for most MCD in human immunodeficiency virus (HIV)-infected patients. Diagnosis is usually determined by lymph node biopsy. Bone marrow findings in KSHV-MCD are not well characterized. We conducted histomorphologic and immunohistochemical evaluation of bone marrow biopsy specimens in HIV-infected patients with KSHV-MCD, including evaluation for KSHV latency-associated nuclear antigen. Findings were correlated with clinical features and KSHV viral load. Reactive plasmacytosis was the predominant feature. Lymphoid aggregates were less common and not diagnostic of KSHV-MCD. Forty-eight percent of cases contained scattered KSHV-infected mononuclear cells. Although patients were generally cytopenic, bone marrow biopsy specimens were normocellular to hypercellular except in patients receiving hematotoxic therapy. Bone marrow biopsy specimens in KSHV-MCD patients recapitulate findings of interleukin-6 excess. In patients with HIV, unexplained cytopenias, and bone marrow plasmacytosis, evaluation for KSHV-MCD is warranted.
卡波西肉瘤疱疹病毒（KSHV），又称人类疱疹病毒 8 型，与 1 种多中心 Castleman 病（MCD）有关，是人类免疫缺陷病毒（HIV）感染患者中大多数 MCD 的病原体。诊断通常通过淋巴结活检确定。KSHV-MCD 的骨髓发现尚未得到很好的描述。我们对 HIV 感染的 KSHV-MCD 患者的骨髓活检标本进行了组织形态学和免疫组织化学评估，包括对 KSHV 潜伏相关核抗原的评估。结果与临床特征和 KSHV 病毒载量相关。反应性浆细胞增多症是主要特征。淋巴样聚集较少见，不能诊断为 KSHV-MCD。48%的病例含有散在的 KSHV 感染的单核细胞。尽管患者通常存在细胞减少症，但骨髓活检标本除接受血液毒性治疗的患者外，均为正常细胞至细胞增多。KSHV-MCD 患者的骨髓活检标本再现了白细胞介素 6 过多的发现。在 HIV 感染患者中，对于不明原因的细胞减少症和骨髓浆细胞增多症，应评估是否存在 KSHV-MCD。
