Castleman's disease represents an atypical lymphoproliferative disorder, infrequently associated with various immunologic abnormalities or subsequent development of malignancy such as Kaposi sarcoma, malignant lymphoma and plasmacytoma. Its clinicopathologic features depend on various etiologic factors such as Kaposi sarcoma herpesvirus (KSHV), oversecretion of IL-6, adhesion molecule and follicular dendritic cell dysplasia, etc. To investigate the relationship of Castleman's disease (CD) and the above factors, we reviewed 22 cases of CD. Four cases of KSHV positive CD were detected, all multicentric, plasma cell type, and these cases displayed prominent vascular proliferation, characteristic 'Kaposi-like lesion'. IL-6 and CD54 positive mononuclear cells were scattered in interfollicular areas of KSHV positive cases. Follicular dendritic cell hyperplasia, vascular proliferation, expression of IL-6 and CD54 did not show any significant difference between solitary vs multicentric type, and plasma cell type vs hyaline vascular type. Our study suggests that KSHV positive CD reveals unique pathologic features, and the probable relationship of KSHV and IL-6 and CD54 is discussed.
Adolescence ; Adult ; Biological Markers ; Dendritic Cells, Follicular/pathology ; Epstein-Barr Virus Infections/virology ; Epstein-Barr Virus Infections/epidemiology ; Female ; Germinal Center/pathology ; Giant Lymph Node Hyperplasia/virology ; Giant Lymph Node Hyperplasia/pathology+ACo- ; Giant Lymph Node Hyperplasia/epidemiology ; Giant Lymph Node Hyperplasia/classification ; Herpesviridae Infections/virology ; Herpesviridae Infections/epidemiology ; Herpesvirus 4, Human/isolation +ACY- purification ; Herpesvirus, Kaposi Sarcoma-Associated/isolation +ACY- purification ; Human ; Hyperplasia ; Intercellular Adhesion Molecule-1/analysis ; Interleukin-6/analysis ; Korea/epidemiology ; Lymph Nodes/virology ; Lymph Nodes/pathology ; Lymph Nodes/chemistry ; Male ; Middle Age ; Neovascularization, Pathologic ; Receptors, Complement 3d/analysis ; Retrospective Studies ; Tumor Virus Infections/virology ; Tumor Virus Infections/epidemiology

No abstract available.
Hysterectomy* ; Lymph Node Excision* ; Lymph Nodes*

No abstract available.
Hysterectomy* ; Lymph Node Excision* ; Lymph Nodes*

Castleman's disease (angiofollicular lymph node hyperplasia) is a large benign tumor. Most of the lesion are located in mediastinum, but some presents as an isolated retroperitoneal mass radiographically indistinguishable from retroperitoneal malignancy. We report a case of the hyaline-vascular variant of Castleman's disease presenting as a palpable abdominal mass.
Giant Lymph Node Hyperplasia* ; Lymph Nodes ; Mediastinum

Castleman's disease(CD) is rare in childhood. It is defined as a localized nodal hyperplasia in mediastinum or cervical area. It is also called angiofollicular lymph node hyperplasia, lymph nodal hamartoma, giant lymph node hyperplasia. It was first described in 1956 by Castleman et al. as a lesion of mediastinal mass. The etiology of CD is not clear. The histologic classification of CD is hyaline vascular and plasma cell type. The hyaline-vascular type is more frequent, and characterized by small hyaline-folliclees and interfollicular capillary proliferation. The plasme cell type is characterized by the large follicles with intervening sheets of plasma cells. The clinical classification of CD is solitary and multicentric type. The solitary type is usually asymptomatic but, the multicentric type is usually combined systemic manifestations, such as fever, anemia, hyperglobulinemia. Complete surgical resection of involved lymph nodes is both diagnostic and therapeutic. The prognosis of solitary type is good, in a general way. We experienced CD cases in five-year-old girl, who had a 4x3 cm solid mass in postrior triangle of neck, right. The mass was removed completely and confirmed Castleman's disease microscopically. The histopathologic finding was a proliferation of germinal centers with hyaline thickening of the wall and the interfollicular stroma showed hyperplastic vessels admixed with lymphocytes, plasma cells and eosinophils. She discharged after six days of operation and her prognosis was good.
Anemia ; Capillaries ; Classification ; Eosinophils ; Female ; Fever ; Germinal Center ; Giant Lymph Node Hyperplasia* ; Hamartoma ; Humans ; Hyalin ; Hyperplasia ; Lymph Nodes ; Lymphocytes ; Mediastinum ; Neck ; Plasma Cells ; Prognosis

Follicular dendritic cells (FDC) are non-lymphoid, non-phagocytic accessory cells of the immune system and these cells are essential for antigen presentation and regulation of the reactions in germinal centers. Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm that shows a low-to-intermediate malignant potential. The most commonly involved sites are the lymph nodes, but FDCS may also occur at a variety of extranodal sites, including the oral cavity, tonsils, gastrointestinal tract and liver. We describe here a 79-year-old woman who had FDCS with extensive lymph node involvement, dry cough, and an itching sensation. The patient improved after systemic chemotherapy.
Aged ; Antigen Presentation ; Cough ; Dendritic Cell Sarcoma, Follicular ; Dendritic Cells ; Dendritic Cells, Follicular ; Female ; Gastrointestinal Tract ; Germinal Center ; Humans ; Immune System ; Liver ; Lymph Nodes ; Mouth ; Palatine Tonsil ; Pruritus ; Sensation

BACKGROUND: Nodal marginal zone lymphoma (NMZL) is a rare B-cell neoplasm consisting of heterogeneous cellular components and residual B-cell follicles. Because of such histological features, it is difficult to diagnose NMZL by fine needle aspiration (FNA) cytology. We reviewed FNA cytology of NMZL to identify a cytological clue to avoid misdiagnosing NMZL. METHODS: Histological, cytological, and clinical findings of seven cases of NMZL were reviewed. RESULTS: Most cases showed nodular aggregates of lymphohistiocytes derived from the germinal center irrespective of histological pattern. The cellular components were heterogeneous and composed of mature small lymphocytes, intermediate and large lymphocytes, immunoblasts, tingible body macrophages, and follicular dendritic cells. Intermediate-sized neoplastic cells with a pale nucleus were observed but difficult to identify because of admixed non-neoplastic cells, which outnumbered neoplastic cells. Except for one case with a high proportion of intermediate-sized cells, the other six cases were initially diagnosed as reactive hyperplasia. A flow cytometric analysis was performed in two cases and failed to demonstrate a monoclonal B-cell population. CONCLUSIONS: The FNA showing a reactive hyperplasia-like smear pattern should be carefully observed by experienced cytopathologists to identify intermediate-sized neoplastic cells. Clinical information including the size of the lymph nodes is important to avoid a misdiagnosis.
B-Lymphocytes ; Biopsy, Fine-Needle ; Dendritic Cells, Follicular ; Diagnostic Errors ; Germinal Center ; Hyperplasia ; Lymph Nodes ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Macrophages

A treatment option for early stage breast cancer is nodal evaluation by axillary lymph node dissection (ALND). An alternative to ALND is sentinel lymph node (SLN) biopsy employing radionuclide SLN mapping. This study was designed to investigate the relationship between malignancy spread to the SLN and primary tumor size by reviewing the clinical profile of 20 female breast cancer patients who underwent radionuclide SLN mapping procedure, sentinel lymph node and primary tumor biopsy, as well as axillary lymph node dissection. The accuracy of radionuclide mapping in the identifying the sentinel node and determining the status of the axillary lymph nodes was reviewed. Among the mapped sentinel nodes, 15% were positive for metastatic lymphadenopathy and 85% without malignant spread. The malignant sentinel nodes had a mean size of 5.5 ± 0.87 cm and the negative sentinel nodes had a mean size of 2.95 ±2.2 cm. The SLN identified by radionuclide mapping truly represented the status of the rest of the axillary nodes for the presence or absence of metastatic lymphadenopathy. Primary tumor size is a prognostic factor for cancer spread to the sentinel node. However, the combination of primary tumor histology and tumor size may prove to be a stronger prognostic indicator malignancy spread to the sentinel lymph node.

Human ; Female ; Axilla ; Breast Neoplasms ; Lymph Node Excision ; Lymph Nodes ; Lymphadenopathy ; Prognosis ; Radioisotopes ; Sentinel Lymph Node ; Sentinel Lymph Node Biopsy

Computed tomographic findings of 24 cases of cervical tuberculous lymphadenitis were retrospectively analyzed. We classified the CT findings as 4 types: type 1(homogeneous soft tissue density mass), type 2(central low density with peripheral rim enhancement and with preservation of surrounding fat plane), type 3(central low density with peripheral rim enhancement and with obliteration of surrounding fat plane), type 4(large confluent low density mass, so called "cold abscess") As a result, there were 2 cases(8.3%) of type 1, 7 cases(29.2%) of type 2, 9 cases(37.5%) of type 3, 3 cases(12.5%) of type 4, 1 cases(4.2%) of type 1 combined with type 3, and 2 cases(8.3%) of type 2 combined with type 4. So 22 cases(91.7%) revealed central low density and peripheral rim enhancement, which suggest necrosis. The maximum thickness of enhancing rim was above 2mm in all of 64 definable necrotic lymph nodes and above 4mm in 42(65.5%) lymph nodes, suggesting that the wall of necrotic tuberculous lymphadenitis tends to be thick. We conclude that CT is useful not only for the diagnosis but also for the evaluation of the extent and the status of cervical tuberculous lymphadenitis.
Diagnosis ; Lymph Nodes ; Necrosis ; Retrospective Studies ; Tuberculosis, Lymph Node*

Duodenal gastrointestinal stromal tumors (GISTs) are uncommon and a relatively small subset of GISTs whose optimal surgical procedure has not been well defined. Because submucosal spread and local lymph node involvement is infrequent in GISTs, wide margins with routine lymph node dissection may not be required. Various techniques of limited resection for duodenal GISTs have been described depending on the site and the size of the tumors. In this study, we report two cases of GIST involving the third and fourth portion of the duodenum successfully treated by segmental duodenectomy with end-to-end duodenojejunostomy. This technique should be considered as a treatment option for GIST located at the third and fourth portion of the duodenum.
Duodenum ; Gastrointestinal Stromal Tumors ; Lymph Node Excision ; Lymph Nodes