Castleman`s disease with POEMS syndrome: clinical and histopathological features with regard to lymph nodes and bone marrow
Abstract
Clinical aspects and histopathological features of lymph nodes and the bone marrow were studied in 14 patients with Castleman`s disease. Seven patients were complicated with POEMS syndrome. As compared with those without POEMS, patients with POEMS had higher plasma cell number in the lymph nodes involved, λ-chain preponderance both by immunohistochemistry and free light chain assay and extensive production of VEGF. Pulmonary hypertension appeared to be a constant finding in patients with POEMS. Delayed start of treatment had adverse effect on prognosis. Pathogenesis of amyloidosis and bone lesions in MCD has much in common with that in multiple myeloma. Amyloid deposits may affect lymph nodes and lead to amyloid neuropathy. Bone lesions manifest with combination of lysis and sclerosis. Bone marrow in all patients with multicentric form of Castleman`s disease was hypocellular at presentation, interferon treatment induced epithelioid granulomas in the bone marrow.
Key words
Mikhaylov A.M. – candidate of medical sciences, assistant of the chair for faculty and hospital therapy, е-mail: mihailov_anatolii@mail.ru
Bessmeltsev S.S. – doctor of medical sciences, professor, deputy director, bsshem@hotmail.ru
Ageeva T.A. – doctor of medical sciences, professor of the chair for pathology. е-mail: ageta@mail.ru
Baykov V.V. – doctor of medical sciences, professor of the chair for pathology, е-mail: baikov02@mail.ru
Zaritskiy A.Yu. – doctor of medical sciences, professor, director
Il`in N.V. – doctor of medical sciences, professor, head of the department for hemotherapy
Krivolapov Yu.A. – doctor of medical sciences, professor of chair for pathology
Lapin S.V. – candidate of medical sciences, head of laboratory of molecular diagnostic
Melnichenko V.Ya. – doctor of medical sciences, professor, head of the hematology and transplantation department
Pozharisskiy K.M. – doctor of medical sciences, professor, head of hystochemical laboratory
Pospelova T.I. – doctor of medical sciences, professor, head of the chair for therapy, hematology and transfusiology
Rugal V.I. – doctor of medical sciences, professor, head of morphological department
Trofimov V.I. – doctor of medical sciences, professor, head of the chair for hospital therapy