Castleman's Disease--Plasma-Cell Variant


Figure 1. Low-power View of Plasma-Cell Variant

This subcapsular region has a subcapsular sinus, which disappears near the top of the image, and a follicle with a large GC composed of mixed lymphoid and dendritic cells. The mantle zone is thin and ill-defined. Increased numbers of vessels are present in the IF zone.

Find the GC.

Find the subcapsular sinus.


Figure 2. High-power View of IF Region of PC Variant

Compare this IF region showing sheets of plasma cells with a similar area from the HV nodule (below). Note the prominent cytoplasm and eccentric nuclei of the plasma cells, which are usually polyclonal. Blood vessels here are less prominent than in the HV nodes.

What is the differential diagnosis?



Figure 3. High-Power View of IF Region of CD-HV Nodule

Here, most of the cells are lymphocytes without visible cytoplasm. Markers indicate that most are T cells. Only a few plasma cells, which can be identified by markers for kappa and lambda light chains, can be found. Note the high endothelial venules with prominent endothelium.

Find a high-endothelial venule at the lower right.


Shahidi H, Myers J, Kvale PA. Castleman's disease. Mayo Clin Proc 1995; 70:969-977.

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The differential diagnosis includes conditions associated with plasma cells in lymph nodes, such as autoimmune diseases (rheumatoid arthritis, Sjogren's syndrome), drug reactions, cancer-draining lymphadenopathy, immunosupressive or immunodeficiency states including AIDS, and Hodgkin's disease [1].



























Enlarged, cellular GC































Subcapsular sinus containing some lymphocytes


































High-endothelial venule, one of several in the image