title: Bone marrow findings in HIV-positive patients with Kaposi sarcoma herpesvirus-associated multicentric Castleman disease.
abstract: Kaposi sarcoma herpesvirus (KSHV), also known as human herpesvirus-8, is associated with 1 form of multicentric Castleman disease (MCD) and is the etiologic agent for most MCD in human immunodeficiency virus (HIV)-infected patients. Diagnosis is usually determined by lymph node biopsy. Bone marrow findings in KSHV-MCD are not well characterized. We conducted histomorphologic and immunohistochemical evaluation of bone marrow biopsy specimens in HIV-infected patients with KSHV-MCD, including evaluation for KSHV latency-associated nuclear antigen. Findings were correlated with clinical features and KSHV viral load. Reactive plasmacytosis was the predominant feature. Lymphoid aggregates were less common and not diagnostic of KSHV-MCD. Forty-eight percent of cases contained scattered KSHV-infected mononuclear cells. Although patients were generally cytopenic, bone marrow biopsy specimens were normocellular to hypercellular except in patients receiving hematotoxic therapy. Bone marrow biopsy specimens in KSHV-MCD patients recapitulate findings of interleukin-6 excess. In patients with HIV, unexplained cytopenias, and bone marrow plasmacytosis, evaluation for KSHV-MCD is warranted.
authors.affiliation: Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA.
authors.forename: Girish
authors.initials: G
authors.lastname: Venkataraman
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Uldrick
authors.forename: Karen
authors.initials: K
authors.lastname: Aleman
authors.forename: Deirdre
authors.initials: D
authors.lastname: O'Mahony
authors.forename: Donald S
authors.initials: DS
authors.lastname: Karcher
authors.forename: Seth M
authors.initials: SM
authors.lastname: Steinberg
authors.forename: Mark A
authors.initials: MA
authors.lastname: Raffeld
authors.forename: Vickie
authors.initials: V
authors.lastname: Marshall
authors.forename: Denise
authors.initials: D
authors.lastname: Whitby
authors.forename: Richard F
authors.initials: RF
authors.lastname: Little
authors.forename: Robert
authors.initials: R
authors.lastname: Yarchoan
authors.forename: Stefania
authors.initials: S
authors.lastname: Pittaluga
authors.forename: Irina
authors.initials: I
authors.lastname: Maric
mesh_terms: D000328:Adult; D001854:Bone Marrow Cells / Q000473:pathology*; D019046:Bone Marrow Neoplasms / Q000473:pathology* / Q000821:virology; D005871:Castleman Disease / Q000473:pathology* / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000473:pathology*; D019288:Herpesvirus 8, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012514:Sarcoma, Kaposi / Q000473:pathology* / Q000821:virology; D013154:Spleen / Q000473:pathology; D019562:Viral Load
chemical_list: D004279:DNA, Viral