title: Detection of Epstein-Barr virus-encoded small RNA-expressed myofibroblasts and IgG4-producing plasma cells in sclerosing angiomatoid nodular transformation of the spleen.
abstract: Sclerosing angiomatoid nodular transformation (SANT) of the spleen is a rare inflammatory tumor-like lesion composed of vascular nodules and non-neoplastic stroma including spindle cells and inflammatory cells. The focus of our study was on the stromal proliferating process in SANT. Nine cases of SANT were examined. All cases showed alpha-smooth muscle actin (alpha-SMA) and vimentin on the spindle cells but not CD21, CD31, CD34, CD68, desmin, S100, human herpes virus-8, or anaplastic lymphoma kinase-1. In one case, 20-30% of the myofibroblasts in Epstein-Barr-virus (EBV)-positive spindle cells were detected using double-labeling immunohistochemistry for alpha-SMA and EBV-encoded small RNA in situ hybridization. A quantitative analysis of IgG and IgG4-positive plasma cells (pPCs) in SANT was performed. The median densities of IgG-pPCs and IgG4-pPCs in SANT were approximately four-fold and 13-fold higher than those in the normal spleens, respectively. In addition, there was a statistically significant increase of IgG4/IgG-pPCs ratio in SANT in comparison to the control specimens. In conclusion, the fibrogenesis in a subset of SANT may be associated with EBV-infected myofibroblasts in an overlapping immune reaction indicated by the presence of infiltrating IgG4-pPCs. Further investigation is needed to elucidate the association between SANT and IgG4-related sclerosing disease.
authors.affiliation: Department of Human Pathology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-Ku, 113-8421 Tokyo, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Kashiwagi
authors.forename: Toshio
authors.initials: T
authors.lastname: Kumasaka
authors.forename: Nobukawa
authors.initials: N
authors.lastname: Bunsei
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fukumura
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Yamasaki
authors.forename: Keiko
authors.initials: K
authors.lastname: Abe
authors.forename: Keiko
authors.initials: K
authors.lastname: Mitani
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Abe
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Suda
mesh_terms: D000328:Adult; D000368:Aged; D020031:Epstein-Barr Virus Infections / Q000276:immunology / Q000473:pathology; D005260:Female; D005347:Fibroblasts / Q000276:immunology / Q000473:pathology; D006104:Granuloma, Plasma Cell / Q000175:diagnosis; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology; D018219:Histiocytoma, Benign Fibrous / Q000175:diagnosis / Q000276:immunology / Q000473:pathology* / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000235:genetics; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D032446:Myoblasts / Q000276:immunology / Q000473:pathology; D010950:Plasma Cells / Q000378:metabolism / Q000821:virology; D012367:RNA, Viral / Q000378:metabolism; D013154:Spleen / Q000473:pathology; D013160:Splenic Neoplasms / Q000175:diagnosis / Q000276:immunology / Q000473:pathology* / Q000821:virology
chemical_list: D007074:Immunoglobulin G; D012367:RNA, Viral