Dissolution of the lymphoid follicle is a feature of the HHV8+variant of plasma cell Castleman's disease
Dissolution of the lymphoid follicle is a feature of the HHV8+variant of plasma cell Castleman's disease
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DOI：
10.1097/00000478-200301000-00010
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发表时间：
2003-01-01
影响因子：
5.6
通讯作者：
Jones, D
中科院分区：
文献类型：
--
作者：
Amin, HM;Medeiros, LJ;Jones, D
Castleman病（PCD）的浆细胞变体可能发生在各种临床环境中。最近描述的一种PCD类型是由人类疱疹病毒8（HHV 8）感染引起的。对25例PCD患者的淋巴结进行了研究，其中6例HHV 8+，19例HHV 8-。3例HHV 8 + PCD患者也感染了人类免疫缺陷病毒-1。所有病例的共同特征是滤泡间浆细胞增多和滤泡生发中心增生和退化。仅与HHV 8 + PCD相关的特征包括由套层边界模糊引起的卵泡溶解（p = 0.0001），这些区域内存在非典型浆细胞和免疫母细胞（p = 0.0006），以及比HHV 8- PCD更显著的小叶间血管增生。HHV 8+细胞主要是免疫母细胞和小淋巴细胞，它们高度富集在改变的卵泡的外套层中。这些领域表现出优势的浆细胞样形式表达λ轻链在4/6例。改变生发中心周围的滤泡外成纤维细胞网络表现出显着的上调低亲和力神经生长因子受体在5个HHV 8+的情况下，但在10个HHV 8-的情况下，只有两个。我们得出结论，HHV 8 + PCD是独特的组织学，因为感染的淋巴细胞在外套带的积累，导致渐进溶解的生发中心和周围基质的调节改变。
The plasma cell variant of Castleman's disease (PCD) may occur in a variety of clinical settings. One recently delineated type of PCD is caused by human herpesvirus 8 (HHV8) infection. Lymph nodes from 25 patients with PCD, including six HHV8+ and 19 HHV8- cases, were studied. Three patients with HHV8+ PCD were also infected with human immunodeficiency virus-1. Features common to all cases were interfollicular plasmacytosis and variably hyperplastic and regressed follicle germinal centers. Features associated only with HHV8+ PCD included follicle dissolution resulting from blurring of the mantle zone boundary (p = 0.0001), presence of atypical plasma cells and immunoblasts within these areas (p = 0.0006), and more prominent interfoilicular vascular proliferation than in HHV8- PCD. HHV8+ cells were predominantly immunoblasts and small lymphocytes that were highly enriched in the mantle zones of altered follicles. These areas showed a predominance of plasmacytoid forms expressing lambda light chain in four of six cases. The extrafollicular fibroblastic network surrounding altered germinal centers demonstrated marked upregulation of low-affinity nerve growth factor receptor in five of five HHV8+ cases but in only two of 10 HHV8-cases. We conclude that HHV8+ PCD is distinctive histologically because of the accumulation of infected lymphocytes in the mantle zone leading to progressive dissolution of the germinal center and altered regulation of the surrounding stroma.