Bone marrow manifestations in multicentric Castleman disease
File(s)
Accepted version
Author(s)
Ibrahim, HAH
Balachandran, K
Bower, M
Naresh, KN
Type
Journal Article
Abstract
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 (HHV8-MCD). BM trephine biopsy (BMTB) specimens from 28 patients were revisited. Samples were evaluated for expression of CD3, CD20, CD138, CD68R, glycophorin C, CD42b, HHV8-latency-associated nuclear antigen (LANA1), Epstein–Barr virus-encoded small RNA and light chains. Presence of significant numbers of HHV8-LANA1+ lymphoid/plasmacytic cells, noted in 10/28 cases, was indicative of BM involvement and was associated with low CD4 and CD8 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 HHV8-LANA1 immunohistochemistry.
Date Issued
2016-03-08
Date Acceptance
2015-10-30
Citation
British Journal of Haematology, 2016, 172 (6), pp.923-929
ISSN
1365-2141
Publisher
Wiley
Start Page
923
End Page
929
Journal / Book Title
British Journal of Haematology
Volume
172
Issue
6
Copyright Statement
This is the peer reviewed version of the following article: Ibrahim, H. A. H., Balachandran, K., Bower, M. and Naresh, K. N. (2016), Bone marrow manifestations in multicentric Castleman disease. Br J Haematol, 172: 923–929, which has been published in final form at https://dx.doi.org/10.1111/bjh.13919. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
Grant Number
RDA02 79560
Subjects
Science & Technology
Life Sciences & Biomedicine
Hematology
bone marrow trephine biopsy
multicentric Castleman disease
human immunodeficiency virus
HHV8
Kaposi sarcoma
SARCOMA-ASSOCIATED HERPESVIRUS
KAPOSI-SARCOMA
HIV-INFECTION
POSITIVE PATIENTS
RITUXIMAB
INTERLEUKIN-6
CELLS
Publication Status
Published