Molina T, Brouland J P, Bigorgne C, Le Tourneau A, Delmer A, Audouin J, Diebold J
Service d'Anatomie et de Cytologie Pathologiques, Hôtel Dieu, Paris.
Ann Pathol. 1996;16(2):133-6.
The authors report the case of a 35 year-old polynesian male admitted to hospital with a diagnosis of myeloma. Bone marrow study showed an intense plasmocytosis, mature, Marshalko type. A new physical examination disclosed polyadenopathies and the lymph node biopsy showed lymph node modifications typical of plasma cell type Castleman's disease. At the same time, the polytypic profile of the bone marrow plasmacytosis and of the hypergammaglobulinemia was demonstrated, thus confirming the reactive state of the plasmacytosis, due to Castleman's disease. Such massive, reactive plasmacytosis belong to one of the various pathological features of multicentric Castleman's disease. Thus, this disease should belong to the etiologic diagnosis of intense bone marrow plasmacytosis and be distinguished from multiple myeloma, sometimes associated to Castleman's disease, especially in case of POEMS syndrome.
作者报告了一例35岁的波利尼西亚男性因骨髓瘤诊断入院的病例。骨髓检查显示有强烈的浆细胞增多，成熟，马氏型。重新进行体格检查发现多处淋巴结肿大，淋巴结活检显示出典型的浆细胞型Castleman病的淋巴结改变。同时，证实了骨髓浆细胞增多和高球蛋白血症的多型性特征，从而确认了由于Castleman病导致的浆细胞增多的反应状态。这种大量的反应性浆细胞增多属于多中心Castleman病的各种病理特征之一。因此，这种疾病应属于强烈骨髓浆细胞增多的病因诊断，并且应与有时与Castleman病相关的多发性骨髓瘤相区分，尤其是在POEMS综合征的情况下。
