Comparison of Plasma Cell Type of Castleman’s Disease and IgG4-Related Sclerosing Disease: A Histopathological and Immunohistochemical Study

Jo, Jeong Hyeon; Park, Young Soo; Jeon, Yoon Kyung; Nam, Soo Jeong; Huh, Jooryung

doi:10.1159/000327357

Cited by 10 publications

(5 citation statements)

References 33 publications

(10 reference statements)

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“…The diagnosis should be confirmed by histological examination, and traditionally three histological variants are distinguished. Castleman disease is closely mimicked by IgG4-related sclerosing disease, in Jo et al (2011). The conclusive diagnosis in our patient was Castleman like disease that is presented as autoinflammatory syndrome.…”

Section: Case Reportsupporting

confidence: 55%

A Post-Vaccination Autoinflammatory Syndrome

Rosipal¹,

Gresikova²,

Rosipal³

2014

IMMU

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The current massive vaccination brings a Janus-faced problem. There is a need to assess a positive effect but also to anticipate the abnormal immune response. Repeated administration of aluminum containing vaccines represents a possible risk factor for different aberrant reactions including the autoinflammatory syndrome that at this stage can be called enigmatic post-vaccination phenomena. Described case gave rise to the suggestion that vaccination could cause the undesired and unintentional hyper activation of the inflammatory system due to lymph node hyperplasia. Castleman like disease is presented as autoinflammatory syndrome. The dysfunction in the immune/inflammatory response seems to play an etiologic role and leads to a high degree of systemic, sterile inflammation. A temporal relationship between vaccination and the adverse reactions, latency period, can involve weeks and months. Autoinflammatory disease is interesting by severe chronic anemia of inflammation and with decreased levels in serum lipid profile. The extirpation of localized lymphoid tumor in the abdomen was beneficial to the patient and immediately ended-up the inflammatory state and normalized the abnormal laboratory results. Studies addressing this issue are limited.

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Section: Case Reportsupporting

confidence: 55%

A Post-Vaccination Autoinflammatory Syndrome

Rosipal¹,

Gresikova²,

Rosipal³

2014

IMMU

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“…Pathologically, a number of studies had expounded the differences between IgG4-RD and CD. One study in Korean pathologically analyzed 87 CD patients and found that the mean IgG4+/IgG+ plasma cell ratio was 25.1% [15]. Sato et al [16] reported that the mean IgG4+/IgG+ plasma cell ratio was 57.6% in IgG4-RD patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of a concurrent condition of IgG4-RD and Castleman’s disease

et al. 2018

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IgG4-related disease (IgG4-RD) and Castleman's disease (CD) share similar clinical manifestations. When the histopathology coincides with the diagnosis of both IgG4-RD and CD, it is hard to depart the two disease entities utterly; here we call it IgG4-CD provisionally. In this study, we aim to review the clinical features of IgG4-CD. This study is based on a retrospective analysis of a prospectively acquired database. IgG4-CD was defined histopathologically in patients who fulfilled the diagnosis of both IgG4-RD and CD. Forty-five definite IgG4-RD and 16 multicentric CD (MCD) patients were recruited as controls. Clinical features including organ involvement, serum IgG4, IgG, IgE, ESR, CRP, and IL-6 levels were collected and analyzed. Fifteen patients (2.8%) out of 534 patients with IgG4-RD in China's largest prospective IgG4-RD and Mimicry cohort fulfilled the definition of IgG4-CD. There were 14 males and 1 female, whose mean age was 47 ± 18 years old, and the median disease duration before diagnosis was 12 (1-132) months. Eight patients have allergic disease history. IgG4-CD patients had more lymph node involvement (100 vs 57.8%, P < 0.01), while IgG4-RD patients had more submandibular (33.3 vs 77.1%, P < 0.01) and parotid gland (13.3 vs 40.9%, P < 0.05) affected. IgG4-CD patients had significantly higher levels of ESR, CRP, IgG, IgG1, IgG3, IgG4, and IgE than IgG4-RD patients. Compared with MCD patients, IgG4-CD patients showed higher incidence of salivary gland and paranasal sinus involvement, higher hemoglobin, eosinophil count, serum IgG4 level and IgG4/IgG ratio, and lower CRP, IL-6 levels, and IgG1/IgG, IgG2/IgG ratio. All patients with IgG4-CD exhibited relatively favorable outcomes. Both IgG4-RD and CD can involve multiple organs. There are a small group of patients who had clinical and pathological characteristics of both CD and IgG4-RD showed better clinical outcome. In the long-term prognosis of these patients, the relationship of CD and IgG4-RD is waiting to be further elucidated.

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“…Systemic IgG4-related lymphadenopathy could mimic the clinical signs of MCD. [ 23 – 25 ] Therefore, it is important to make a differential diagnosis between MCD and IgG4-RD. Although some patients with definite IgG4-RD show normal serum IgG4 concentrations, the elevation of serum IgG4 is more common in patients with IgG4-RD, and serum IgG4 levels ≥135 mg/dL is 1 of the major diagnostic criteria for IgG4-RD.…”

Section: Discussionmentioning

confidence: 99%

“…[ 26 – 29 ] However, an elevated serum IgG4 level is not specific for IgG4-RD as it can also be associated with non-IgG4-RDs, for example, hematological malignancies and allergic diseases, especially MCD with the PC or mixed variant. [ 23 – 25 ] However, higher levels of serum IL-6 and IgG, along with increases in IgM and/or IgA, and differences in the IgG4 + /IgG + ratio and morphological manifestations in the involved tissue [ 23 , 24 ] have been seen in MCD cases. Patients with IgG4-RD have elevated serum IgG4 levels, but most of them have normal levels or lower increases in serum IL-6.…”

Section: Discussionmentioning

confidence: 99%

Castleman disease-associated diffuse parenchymal lung disease

Huang¹,

Feng

Li³

et al. 2017

Medicine

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Intrathoracic involvement is common in Castleman disease (CD), but CD-associated diffuse parenchymal lung disease (DPLD) is rare and not well-reported.We conducted a retrospective analysis of 262 CD patients with a definite pathological diagnosis who were hospitalized between 1999 and 2015.Twenty-two CD patients had DPLD based on chest computed tomography (CT) scans. Among them, 9 were male and 13 were female, with a mean age of 45.3 years. Coughing (72.7%), fever (68.2%), and dyspnea (59.1%) were the common clinical manifestations. In high-resolution CT, obvious lymphadenopathy (81.8%) was the most frequent, followed by multiple nodules of different sizes (72.7%), cysts (59.1%), and patches of ground-glass opacity (54.5%). Six patients had lymphocytic interstitial pneumonia (LIP)-like CT images. Superficial lymph node biopsies (63.6%), video-assisted thoracic surgery lung biopsies (27.3%), CT-guided percutaneous lung biopsies (9.1%), and endoscopic lymph node biopsies (9.1%) were performed to make final diagnoses. The hyaline vascular variant (27.3%), the plasma cell variant (63.6%), and the mixed variant (9.1%) were the pathological subtypes. All but 2 were prescribed chemotherapy, and none was administered anti-interleukin-6 therapy. Among them, 14 patients improved, 3 died, 2 were stable, 2 were refractory, and 1 was lost to follow-up.Chinese CD-associated DPLD might be more prevalent in middle-aged female patients, with most cases being the plasma cell variant. Although a LIP-like pattern was reported, only one-quarter of the patients showed LIP-like CT images. Multiple nodules (especially solid nodules), cysts, and patchy areas were the common pulmonary radiological findings. More than half of the patients improved after chemotherapy. A well-designed prospective study should be performed to confirm these results.

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Comparison of Plasma Cell Type of Castleman’s Disease and IgG4-Related Sclerosing Disease: A Histopathological and Immunohistochemical Study

Cited by 10 publications

References 33 publications

A Post-Vaccination Autoinflammatory Syndrome

A Post-Vaccination Autoinflammatory Syndrome

Clinical characteristics of a concurrent condition of IgG4-RD and Castleman’s disease

Castleman disease-associated diffuse parenchymal lung disease

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