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- Title
Bone marrow manifestations in multicentric Castleman disease.
- Authors
Ibrahim, Hazem A. H.; Balachandran, Kirsty; Bower, Mark; Naresh, Kikkeri N.
- Abstract
This study aimed to document the morphological and immunophenotypic features, and describe the diagnostic features of bone marrow ( BM) involvement in human herpes virus 8 Multicentric Castleman disease ( HHV8- MCD). BM trephine biopsy ( BMTB) specimens from 28 patients were revisited. Samples were evaluated for expression of CD3, CD20, CD138, CD68R, glycophorin C, CD42b, HHV8-latency-associated nuclear antigen ( LANA1), Epstein-Barr virus-encoded small RNA and light chains. Presence of significant numbers of HHV8- LANA1+ lymphoid/plasmacytic cells, noted in 10/28 cases, was indicative of BM involvement and was associated with low CD4 and CD8 counts in peripheral blood. The characteristic morphological appearance of MCD seen in lymph nodes is a rare finding in BMTB. 4/5 cases with lymphoid aggregates were involved by MCD, whereas 6/23 cases without lymphoid aggregates were involved by MCD ( P = 0·023). 9/18 cases with hypercellular marrow were involved by MCD, whilst only 1/8 cases with normo/hypocellular marrow showed involvement by MCD ( P = 0·070). While 9/21 cases with increased marrow reticulin were involved by MCD, none of the cases with no increase in reticulin were involved by MCD ( P = 0·080). Reactive plasmacytosis is a frequent finding. We conclude that bone marrow is involved in a significant proportion of patients with MCD (36%), and involvement can be identified by HHV8- LANA1 immunohistochemistry.
- Subjects
CASTLEMAN'S disease; BONE marrow; IMMUNOPHENOTYPING; HERPESVIRUS diseases; IMMUNOHISTOCHEMISTRY; HIV; KAPOSI'S sarcoma
- Publication
British Journal of Haematology, 2016, Vol 172, Issue 6, p923
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.13919