Abstract | BACKGROUND: RESULTS: In the present series, the patients showed systemic lymphadenopathy, polyclonal hypergammaglobulinaemia and elevated serum interleukin-6 (IL-6) and C-reactive protein levels. Further, anaemia, hypoalbuminaemia, hypocholesterolaemia and thrombocytosis were observed. These findings were consistent with those of multicentric Castleman's disease. Although five patients showed elevated serum IgG4 levels, only two patients showed an increased serum IgG4/ IgG ratio. However, the two patients showed highly elevated serum IgG4 levels, but the serum IgG4/ IgG ratios were, although increased, not very high. Also, a patient with increased serum IgG4/ IgG ratio showed a good response to antihuman IL-6 receptor monoclonal antibody ( tocilizumab). Histologically, the germinal centres were mostly small and regressive, and frequently penetrated by hyalinised blood vessels, and there was no eosinophil infiltration. These findings were different from those of IgG4-related lymphadenopathy. CONCLUSIONS: The authors conclude that multicentric Castleman's disease sometimes occurs with abundant IgG4-positive cells and elevated serum IgG4 levels. Therefore, the two diseases cannot be differentially diagnosed by immunohistochemical staining alone. Laboratory findings, especially IL-6 level, C-reactive protein level and platelet count, are important for the differential diagnosis of the two diseases.
|
Authors | Yasuharu Sato, Masaru Kojima, Katsuyoshi Takata, Toshiaki Morito, Kohichi Mizobuchi, Takehiro Tanaka, Dai Inoue, Hideyuki Shiomi, Haruka Iwao, Tadashi Yoshino |
Journal | Journal of clinical pathology
(J Clin Pathol)
Vol. 63
Issue 12
Pg. 1084-9
(Dec 2010)
ISSN: 1472-4146 [Electronic] England |
PMID | 20974624
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Biomarkers
- Immunoglobulin G
- Interleukin-6
- C-Reactive Protein
|
Topics |
- Adult
- Aged
- Biomarkers
(analysis, blood)
- Biopsy
- C-Reactive Protein
(analysis)
- Castleman Disease
(diagnosis, pathology)
- Diagnosis, Differential
- Female
- Gene Rearrangement, B-Lymphocyte, Heavy Chain
- Humans
- Immunoglobulin G
(analysis, blood)
- Interleukin-6
(analysis)
- Lymph Nodes
(pathology)
- Lymphatic Diseases
(diagnosis, pathology)
- Male
- Middle Aged
|