Monoclonality and cytogenetic abnormalities in hyaline vascular Castleman disease

Hyaline vascular Castleman disease is traditionally regarded as a reactive hyperplastic process. Occasional cases, however, have been reported with cytogenetic anomalies bringing this concept into question. In this study, we used conventional and methylation-specific polymerase chain reaction method...

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Bibliographic Details
Published in:	Modern pathology 2014-06, Vol.27 (6), p.823-831
Main Authors:	Chang, Kung-Chao, Wang, Yu-Chu, Hung, Liang-Yi, Huang, Wan-Ting, Tsou, Jen-Hui, M Jones, Dan, Song, Hsiang-Lin, Yeh, Yu-Min, Kao, Lin-Yuan, Medeiros, L Jeffrey
Format:	Article
Language:	eng
Subjects:	Abnormal Karyotype Adolescent Adult Aged Castleman Disease - genetics Castleman Disease - pathology Child Child, Preschool Chromosome Aberrations Clone Cells cytogenetic abnormalities Female Gene Rearrangement human androgen receptor α gene Humans hyaline vascular Castleman disease Immunohistochemistry Middle Aged monoclonal proliferation Polymerase Chain Reaction Receptors, Androgen - genetics Receptors, Antigen, T-Cell - genetics stromal cells Stromal Cells - pathology Young Adult
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Summary:	Hyaline vascular Castleman disease is traditionally regarded as a reactive hyperplastic process. Occasional cases, however, have been reported with cytogenetic anomalies bringing this concept into question. In this study, we used conventional and methylation-specific polymerase chain reaction methods to assess the human androgen receptor α (HUMARA) gene in 29 female patients with hyaline vascular Castleman disease and compared the results with three cases of plasma cell Castleman disease and 20 cases of age-matched lymphoid hyperplasia. We also assessed for immunoglobulin gene and T-cell receptor gene rearrangements, and conventional cytogenetic analysis was performed in three cases of hyaline vascular Castleman disease. In cases with informative results, conventional and methylation-specific human androgen receptor α gene analyses yielded a monoclonal pattern in 10 of 19 (53%) and 17 of 23 (74%) cases of hyaline vascular Castleman disease, respectively. A monoclonal pattern was also detected in three cases of plasma cell Castleman disease but not in cases of lymphoid hyperplasia. The frequency of monoclonality was higher for lesions >5 cm in size (100%) and for the stromal-rich variant (91%). Cytogenetic abnormalities in stromal cells were revealed in two cases of hyaline vascular Castleman disease and no cases showed monoclonal immunoglobulin or T-cell receptor gene rearrangements. Follow-up data showed persistent disease in 4 of 23 (17%) patients. We conclude that hyaline vascular Castleman disease is often a monoclonal proliferation, most likely of lymph node stromal cells.
ISSN:	0893-3952 1530-0285