Histological diversity of reactive and atypical proliferative lymph node lesions in systemic lupus erythematosus patients

Kojima, Masaru; Motoori, Tadashi; Asano, Shigeyuki; Nakamura, Shigeo

doi:10.1016/j.prp.2007.03.002

Cited by 82 publications

(50 citation statements)

References 32 publications

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“…For instance, nearly all enlarged lymph nodes from patients with RA and 15% to 30% of SLE display MCD-like histopathology. [39][40][41][42] Therefore, disorders that can mimic iMCD should be excluded before a diagnosis of iMCD is accepted. The diagnostic evaluation required to exclude other diseases should be based on the clinical presentation, and may require additional biopsies, serologic or microbiology studies as indicated, and careful clinical correlation.…”

Section: Exclusion Criteriamentioning

confidence: 99%

International, evidence-based consensus diagnostic criteria for HHV-8–negative/idiopathic multicentric Castleman disease

Fajgenbaum

Uldrick

Bagg

et al. 2017

Blood

403

618

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Section: Exclusion Criteriamentioning

confidence: 99%

International, evidence-based consensus diagnostic criteria for HHV-8–negative/idiopathic multicentric Castleman disease

Fajgenbaum

Uldrick

Bagg

et al. 2017

Blood

403

618

View full text Add to dashboard Cite

show abstract

“…9,10,12 Of note, these histopathological features are nonspecific, reactive to hypercytokinemia from any source in the body, and can be found in several infectious, rheumatologic, and neoplastic diseases (Table 1). 3,[22][23][24] Thus, iMCD lymph nodes should not be considered tumors. The plasmablastic variant is only found in HHV-8-associated MCD and will not be discussed.…”

Section: Pathological and Clinical Featuresmentioning

confidence: 99%

“…Nearly all lymph nodes of rheumatoid arthritis patients and 15% to 30% of systemic lupus erythematous (SLE) lymph nodes display MCD-like histopathology. 3,[22][23][24] 2. IMCD involves intense episodes of inflammation that are clinically similar to autoimmune and autoinflammatory diseases, such as SLE, adult-onset Still's disease, periodic fever syndromes, and hemophagocytic syndromes.…”

Section: Systemic Inflammatory Disease Hypothesismentioning

confidence: 99%

HHV-8-negative, idiopathic multicentric Castleman disease: novel insights into biology, pathogenesis, and therapy

Fajgenbaum

Rhee

Nabel

2014

Blood

267

255

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Multicentric Castleman's disease (MCD) describes a heterogeneous group of disorders involving proliferation of morphologically benign lymphocytes due to excessive proinflammatory hypercytokinemia, most notably of interleukin-6. Patients demonstrate intense episodes of systemic inflammatory symptoms, polyclonal lymphocyte and plasma cell proliferation, autoimmune manifestations, and organ system impairment. Human herpes virus-8 (HHV-8) drives the hypercytokinemia in all HIV-positive patients and some HIV-negative patients. There is also a group of HIV-negative and HHV-8-negative patients with unknown etiology and pathophysiology, which we propose referring to as idiopathic MCD (iMCD). Here, we synthesize what is known about iMCD pathogenesis, present a new subclassification system, and propose a model of iMCD pathogenesis. MCD should be subdivided into HHV-8-associated MCD and HHV-8-negative MCD or iMCD. The lymphocyte proliferation, histopathology, and systemic features in iMCD are secondary to hypercytokinemia, which can occur with several other diseases. We propose that 1 or more of the following 3 candidate processes may drive iMCD hypercytokinemia: systemic inflammatory disease mechanisms via autoantibodies or inflammatory gene mutations, paraneoplastic syndrome mechanisms via ectopic cytokine secretion, and/or a non-HHV-8 virus. Urgent priorities include elucidating the process driving iMCD hypercytokinemia, identifying the hypercytokine-secreting cell, developing consensus criteria for diagnosis, and building a patient registry to track cases.

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“…Except for necrosis, lymph node changes in SLE are generally characterized by follicular hyperplasia which is usually considered to be nonspecific. As a result, little attention has been paid to the histopathological or immunohistochemical examination of lymph nodes in patients with SLE [1]. However, since the late 1990s, a number of cases of SLE lymphadenopathy have been reported exhibiting a Castleman's disease (CD) morphology, which was discovered in lymph node biopsies for the purpose of excluding malignant lymphoma.…”

Section: Introductionmentioning

confidence: 99%

A case report of systemic lupus erythematosus combined with Castleman’s disease and literature review

Xia

Chen

et al. 2010

Rheumatol Int

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Although lymph node enlargement is common in active systemic lupus erythematosus (SLE), lymph node examination is frequently ignored in the diagnosis of SLE. Clinical presentation and abnormal laboratory findings are often sufficient for SLE diagnosis, not to mention that the specific histological finding of lymph node necrosis in SLE is rarely seen, and the follicular hyperplasia is usually considered as nonspecific. However, since the late 1990s, a few cases of SLE lymphadenopathy have been reported exhibiting a Castleman's disease (CD) morphology, which was discovered in lymph node biopsies. Here we report a similar case of SLE combined with CD in a 23-year-old girl who displayed systemic symptoms, including systemic lymphadenopathy and abnormal laboratory findings indicating the active phase of SLE. A biopsy of neck lymphnodes showed histopathological features of CD. The patient responded very well to the prednisolone treatment. Based on the related literature review, we would like to stress the possibility of CD in patients with SLE lymphadenopathy.

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Histological diversity of reactive and atypical proliferative lymph node lesions in systemic lupus erythematosus patients

Cited by 82 publications

References 32 publications

International, evidence-based consensus diagnostic criteria for HHV-8–negative/idiopathic multicentric Castleman disease

International, evidence-based consensus diagnostic criteria for HHV-8–negative/idiopathic multicentric Castleman disease

HHV-8-negative, idiopathic multicentric Castleman disease: novel insights into biology, pathogenesis, and therapy

A case report of systemic lupus erythematosus combined with Castleman’s disease and literature review

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