Clinicopathologic changes of lymph nodes adjacent to hyaline-vascular Castleman disease

Objective To describe the histologic features of lymph nodes adjacent to hyaline-vascular Castleman disease(HVCD)lesions.Methods Seven cases of HVCD in which adjacent lymph nodes were available were identified.H-E stained sections were examined and immunohistochemical staining was performed.Results All the lymph nodes had preserved sinuses,and showed many follicles.Most follicles had small or no germinal centers,and presented apparently prominent mantle zones.However,in immunostaining for mantle cells(lgD),mantle zones were genuinely thickened in 3 cases;most follicles actually showed marginal zone rather than mantle zone hyperplasia.Occasional regression of germinal center(5 cases),onion-skining of mantle zone(2 cases),hyaline vessels in germinal center(1 case)and follicles with multiple germinal centers(1 case)were identified in this group.In interfollicular zone,prominently hyperplasia of high endothelial venules were not observed.Conclusions Lymph nodes adjacent to HVCD lesions can show some incompletely developed features of HVCD and follicles with apparently thick mantle zone.The findings of these features in lymph nodes may prompt the possibility of nearby HVCD if a small lymph node adjacent to a large lesion is biopsied.