Hyaline-vascular type of Castleman's disease (angiofollicular lymph node hyperplasia) with monotypic plasma cells. An immunohistochemical study with monoclonal antibodies

A case of angiofollicular lymph node hyperplasia (Castleman's disease) characterized by monotypic (IgG+, lambda+) plasmacytosis is described. Fresh tissue was available and a thorough immunohistochemical analysis of lymphoid and non-lymphoid cells was performed on cryostat sections. Although lymphoid follicles were numerous and exhibited some abnormal features they did not appear part of the monoclonal cell proliferation. Follicular lymphocytes were mixtures of Kappa+ and lambda+ cells. Vessels penetrating within these abnormal follicles expressed reduced levels of FVIII and Leu-M5 antigens and exhibited thicker layer of collagen type IV. The analysis of T-cell subsets showed a normal (3:1) T4/T8 ratio. This case extends to the mixed variant of hyaline-vascular Castleman's disease, the neoplastic potential previously associated to the plasma cell variant of the disease.