Kurose Nozomu, Mizutani Ken-Ichi, Kumagai Motona, Shioya Akihiro, Guo Xin, Nakada Satoko, Fujimoto Shino, Kawabata Hiroshi, Masaki Yasufumi, Takai Kazue, Aoki Sadao, Kojima Masaru, Nakamura Shigeo, Kida Masatoshi, Yamada Sohsuke
Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Ishikawa, Japan.
Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Ishikawa, Japan.
Pathol Res Pract. 2019 Mar;215(3):410-413. doi: 10.1016/j.prp.2018.12.025. Epub 2018 Dec 26.
Thrombocytopenia, anasarca, fever, renal failure or reticulin fibrosis, and organomegaly (TAFRO) syndrome, a poor prognostic clinical condition showing similar histopathological findings to idiopathic multicentric Castleman disease (iMCD), has been reported in Japan. In our previous report, a clinicopathological analysis was performed on 70 nodal cases of iMCD with/without TAFRO. iMCD is classified into three types based on histopathology: (i) plasmacytic (PC), (ii) mixed, and (iii) hypervascular (hyperV). In this report, extranodal histopathological changes of iMCD with/without TAFRO were analyzed. Regarding the kidney pathology, we observed the proliferation of mesangial cells with positive staining of interleukin-6 (IL-6), consistent with membranoproliferative glomerulonephritis, in two cases of iMCD with TAFRO. The number of megakaryocytes per high-powered fields was not significantly different between iMCD cases with and without TAFRO. In conclusion, extranodal lesions of iMCD with/without TAFRO showed various interesting histopathological findings. These lesions may therefore be related to the clinical condition of TAFRO. Obtaining further knowledge about TAFRO will require the observation of nodal as well as extranodal lesions.
血小板减少、全身性水肿、发热、肾衰竭或网状纤维组织增生以及器官肿大（TAFRO）综合征是一种预后不良的临床病症，在日本已有报道，其组织病理学表现与特发性多中心Castleman病（iMCD）相似。在我们之前的报告中，对70例有或无TAFRO的iMCD淋巴结病例进行了临床病理分析。iMCD根据组织病理学分为三种类型：（i）浆细胞型（PC），（ii）混合型，以及（iii）血管增生型（hyperV）。在本报告中，分析了有或无TAFRO的iMCD的结外组织病理学变化。关于肾脏病理，在两例有TAFRO的iMCD病例中，我们观察到系膜细胞增生，白细胞介素-6（IL-6）染色呈阳性，符合膜增生性肾小球肾炎。有TAFRO和无TAFRO的iMCD病例之间，每高倍视野巨核细胞数量无显著差异。总之，有或无TAFRO的iMCD结外病变表现出各种有趣的组织病理学发现。因此，这些病变可能与TAFRO的临床病症有关。要进一步了解TAFRO，需要观察淋巴结及结外病变。
