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Bone marrow manifestations in multicentric Castleman disease
Author(s) -
Ibrahim Hazem A. H.,
Balachandran Kirsty,
Bower Mark,
Naresh Kikkeri N.
Publication year - 2016
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13919
Subject(s) - pathology , bone marrow , plasmacytosis , medicine , cd20 , cd3 , immunohistochemistry , biopsy , cd8 , antigen , immunology
Summary This study aimed to document the morphological and immunophenotypic features, and describe the diagnostic features of bone marrow ( BM ) involvement in human herpes virus 8 Multicentric Castleman disease ( HHV 8‐ MCD ). BM trephine biopsy ( BMTB ) specimens from 28 patients were revisited. Samples were evaluated for expression of CD 3, CD 20, CD 138, CD 68R, glycophorin C, CD 42b, HHV 8‐latency‐associated nuclear antigen ( LANA 1), Epstein–Barr virus‐encoded small RNA and light chains. Presence of significant numbers of HHV 8‐ LANA 1 + lymphoid/plasmacytic cells, noted in 10/28 cases, was indicative of BM involvement and was associated with low CD 4 and CD 8 counts in peripheral blood. The characteristic morphological appearance of MCD seen in lymph nodes is a rare finding in BMTB . 4/5 cases with lymphoid aggregates were involved by MCD , whereas 6/23 cases without lymphoid aggregates were involved by MCD ( P = 0·023). 9/18 cases with hypercellular marrow were involved by MCD , whilst only 1/8 cases with normo/hypocellular marrow showed involvement by MCD ( P = 0·070). While 9/21 cases with increased marrow reticulin were involved by MCD , none of the cases with no increase in reticulin were involved by MCD ( P = 0·080). Reactive plasmacytosis is a frequent finding. We conclude that bone marrow is involved in a significant proportion of patients with MCD (36%), and involvement can be identified by HHV 8‐ LANA 1 immunohistochemistry.