title: Monoclonality and polyclonality of plasma cells in Castleman's disease of the plasma cell variant.
abstract: Castleman's disease of the plasma cell variant observed in 21 patients was investigated morphologically and by immunohistochemistry. The male to female ratio was 2.5:1. The age ranged from 18 to 71 years (mean age 47.6 years). Histologically, the lesions were characterized by numerous, evenly distributed germinal centres ranging from large hyperplastic to small hyaline-vascular types with moderate to extensive sheets of plasma cells in between. In all cases with generalized lymph node enlargement dilated sinuses could be found. Immunohistochemical studies demonstrated a polyclonal plasma cell population in 11 of 18 lesions. Seven lesions contained a monoclonal plasma cell population, five with IgG/lambda and two with IgA/lambda; clinically, two of these patients had generalized lymphadenopathy; in none could manifestation of a plasmacytoma be found outside the lymph node lesion; only two of the seven patients exhibited a paraproteinaemia (IgG/lambda and IgA/lambda, respectively) corresponding to the Ig type of the proliferated plasma cells. Six patients with polyclonal lesions had constitutional symptoms such as fever, anaemia, polyclonal hypergammaglobulinaemia; one of these six patients manifested symptoms consistent with a diagnosis of Takatsuki syndrome. The monoclonal plasma cell type of Castleman's disease did not progress to a generalized disease. This monoclonal variant may be a lymph nodebased type of benign monoclonal gammopathy.
authors.affiliation: Institute of Pathology, University of Vienna, Austria.
authors.forename: T
authors.initials: T
authors.lastname: Radaszkiewicz
authors.forename: M L
authors.initials: ML
authors.lastname: Hansmann
authors.forename: K
authors.initials: K
authors.lastname: Lennert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005871:Castleman Disease / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010950:Plasma Cells / Q000276:immunology* / Q000473:pathology
chemical_list: D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M