title: Monoclonality and cytogenetic abnormalities in hyaline vascular Castleman disease.
abstract: 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.
authors.affiliation: Department of Pathology, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan.
authors.forename: Kung-Chao
authors.initials: KC
authors.lastname: Chang
authors.affiliation: Institute of Bioinformatics and Biosignal Transduction, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Yu-Chu
authors.initials: YC
authors.lastname: Wang
authors.affiliation: Institute of Bioinformatics and Biosignal Transduction, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Liang-Yi
authors.initials: LY
authors.lastname: Hung
authors.affiliation: Department of Pathology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Wan-Ting
authors.initials: WT
authors.lastname: Huang
authors.affiliation: Institute of Bioinformatics and Biosignal Transduction, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Jen-Hui
authors.initials: JH
authors.lastname: Tsou
authors.affiliation: School of Medicine, The University of Texas Anderson Cancer Center, Houston, TX, USA.
authors.forename: Dan
authors.initials: D
authors.lastname: M Jones
authors.affiliation: Department of Pathology, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan.
authors.forename: Hsiang-Lin
authors.initials: HL
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan.
authors.forename: Yu-Min
authors.initials: YM
authors.lastname: Yeh
authors.affiliation: Department of Pathology, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan.
authors.forename: Lin-Yuan
authors.initials: LY
authors.lastname: Kao
authors.affiliation: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: L Jeffrey
authors.initials: LJ
authors.lastname: Medeiros
mesh_terms: D059786:Abnormal Karyotype; D000293:Adolescent; D000328:Adult; D000368:Aged; D005871:Castleman Disease / Q000235:genetics* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D002869:Chromosome Aberrations; D002999:Clone Cells; D005260:Female; D015321:Gene Rearrangement; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011944:Receptors, Androgen / Q000235:genetics*; D011948:Receptors, Antigen, T-Cell / Q000235:genetics; D017154:Stromal Cells / Q000473:pathology; D055815:Young Adult
chemical_list: C410798:AR protein, human; D011944:Receptors, Androgen; D011948:Receptors, Antigen, T-Cell