Monoclonality and cytogenetic abnormalities in hyaline vascular Castleman disease

Kung Chao Chang, Yu Chu Wang, Liang Yi Hung, Wan Ting Huang, Jen Hui Tsou, Dan M Jones, Hsiang Lin Song, Yu Min Yeh, Lin Yuan Kao, L. Jeffrey Medeiros

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)823-831
Number of pages9
JournalModern Pathology
Volume27
Issue number6
DOIs
Publication statusPublished - 2014 Jun

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

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