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Lymph nodes - not lymphoma
Inflammatory disorders (non-infectious)
Castlemanís disease

Reviewer: William D. DePond, M.D.(see Reviewers page)
Revised: 25 July 2013, last major update June 2006
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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Case reports
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Treatment
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Gross images
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Tan-pink tissue with calcifications

Micro description
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Micro images
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Hyaline vascular variant -

Probable early lesion - a lymphocyte cuff surrounds a pale central area of concentric hyalinized cells, and a small vessel penetrates the cuff and enters the central area

Various images

Cuff of lymphocytes surrounds thick walled vessel


Onion-skin pattern of lymphocytes with abnormal vasculature and multinucleated follicular dendritic cells

Follicle has two pale centers, one irregular; vessel enters from below

Almost total obliteration of subcapsular sinus

Center of follicle has prominent vessel

Reticulin stain shows profusion of small vessels


Extensive proliferation of small, thick walled vessels with prominent endothelial cells

With Kaposiís sarcoma in HIV negative patient receiving cyclosporine A for minimal change nephropathy


AFIP images:

Plasma cell type

Hyaline-vascular type

Vascular neoplasm complicating hyaline-vascular Castleman's disease


Hyaline-vascular Castleman's disease with vascular hyperplasia

Angiolipomatous hamartoma in association with Castleman's disease



Figure 1: follicular hyperplasia with concentric mantle zones
2: interfollicular zones have prominent vascular proliferation
3: targetoid lymphocytes in mantle zone of hyalinized follicles with an occasional capillary penetrating radially into the germinal centers

Figure 1: CT scan
2: 7 cm tumor with rib and vertebrae
3: scrape shows cellular material with discohesive cells containing high N/C ratios
4: H&E shows expanded mantle zone with small lymphocytes arranged in concentric layers


Images contributed by Dr. Jack D. Sublett II, University of Arkansas for Medical Sciences -

Onion skin pattern #1

#2


Case of the Week: low/medium power -

Figure 1

Figure 2

Figure 3

Low power targetoid pattern

Lollipop appearance

Onion skin pattern of lymphocytes


High power -

Figure 4

Figure 5


Plasma cell variant -

Interfollicular space shows numerous mature plasma cells


Plasmablastic variant -

Plasmablastic and plasma cell variant




Cytology description
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Positive stains
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Negative stains
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Molecular description
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Differential diagnosis
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Additional references
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End of Lymph nodes - not lymphoma > Inflammatory disorders (non-infectious) > Castlemanís disease


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