Clinicopathologic Analysis Of Castleman Disease And Preliminary Discussion Of Its Etiology

Purpose:To describe clinicopathological features, diagnosis and differential diagnosis of Castleman disease.Methods:Retrospectively analyzed clinical data, clinicopathology and immunohistochemistry in 10 cases of Castleman disease, combined with review of literatures.Results:There were 8 cases of unicenrtic, while 2 cases of multicentric in 10 cases of Castleman disease. Pathologically, there were 6 cases of hayline vascular types, one case of plasmatcyic type and 3 cases of mixed type. Immunohistochemical features:all cases were negative for BCL-6 and CD10, and Ki-67 expression were reduced (proliferation index was less than or equal to 30%). There were 4 cases with completed follow-up data, including one case of intermediate type,3 cases of hyaline vascular type, which were all healed by surgical resection without recurrence.Conclusions:Castleman disease is a rare disease which has an unknown cause with lymphoproliferative disorders and it is not easy to diagnose before the operation. Fully understanding of Castleman disease is crucial for avoiding misdiagnosis. If mmunohistochemical features reflect abnormal immune function and played unknown role in the pathogenesis of Castleman disease or not is also demanded further study.Objective:In this study, using immunohistochemical staining technique to detect the expression of CD 10 and BCL-6 in Castleman disease, reactive lymphoid hyperplasia and follicular lymphoma, and to explore the expression of CD 10 and BCL-6 in Castleman disease and its significance.Methods:Collecting 10 cases of Castleman disease,13 cases of reactive lymphoid hyperplasia and 13 cases of follicular lymphoma diagnosed by department of pathology in 307 hospital from 2000 to 2014. Which including surgical resection specimens and biopsy specimens. And detecting CD10 and BCL-6 expression in such cases by immunohistochemical staining.Results:1.The results of CD 10 expression with IHC staining:The difference between Cattlemen’s disease and reactive lymphoid hyperplasia was statistically significant (single,double-sided P=0.003); while was also statistically significant (single,double-sided P<0.0001) between follicular lymphoma.2.The results of BCL-6 expression with IHC staining:There was statistical significance between Castleman disease and reactive lymphoid hyperplasia and follicular lymphoma (single, double-sided P<0.0001).3.10 cases of Castleman disease in all biopsy specimens showed BCL-6, CD 10 negative in germinal center. Then point out the development of Castleman disease has some relevance with BCL-6 and CD 10.Conclusions:1. CD 10 and BCL-6 can be used as a immunological marker auxiliaried in Castleman disease diagnosis and differential diagnosis with reactive lymphoid hyperplasia and follicular lymphoma.2. BCL-6 have a certain relevance with the development of Castleman disease.