IL-6-positive classical Hodgkin’s lymphoma co-occurring with plasma cell type of Castleman’s disease: report of a case
Tóm tắt
We present a case of classical Hodgkin’s lymphoma (HL) co-occurring with histological features of Castleman’s disease (CD). A 25-year-old man presented with left supraclavicular and axillary lymph node swelling and mediastinal mass. Using an initial biopsy specimen from left axillary lymph node, a tentative diagnosis of multicentric CD of plasma cell type was made. The serum level of interleukin-6 (IL-6) was elevated. The patient was treated with immunosuppressive therapy containing tocilizumab (TCZ). Shrinkage of mediastinal mass and axillary lymph nodes was seen; however, swelling of his left axillary lymph nodes reemerged, even after therapy with TCZ. A second left axillary lymph node biopsy was performed and a diagnosis of nodular sclerosis of classical HL without histologic features of CD was made. The initial biopsy specimen was re-examined, and scattered CD30+ Hodgkin/Reed–Sternberg cells were found in the interfollicular area. Interestingly, Hodgkin/Reed–Sternberg cells and surrounding reactive cells in both lymph nodes were stained with anti-IL-6 antibody. We emphasize that biopsy specimens with HL involvement may also have histologic features reminiscent of those seen in CD. To our knowledge, this is the first report to provide a detailed description of this pathology, including a survey of IL-6 and clinical course upon treatment with TCZ.
Tài liệu tham khảo
Castleman B, Iverson L, Menendez VP. Localized mediastinal lymphnode hyperplasia resembling thymoma. Cancer. 1956;9:822–30.
Larroche C, Cacoub P, Soulier J, Oksenhendler E, Clauvel JP, Piette JC, et al. Castleman’s disease and lymphoma: report of eight cases in HIV-negative patients and literature review. Am J Hematol. 2002;69:119–26.
Kojima M, Nakamura S, Nishikawa M, Itoh H, Miyawaki S, Masawa N. Idiopathic multicentric Castleman”s disease. A clinicopathologic and immunohistochemical study of five cases. Pathol Res Pract. 2005;201:325–32.
Maheswaran PR, Ramsay AD, Norton AJ, Roche WR. Hodgkin’s disease presenting with the histological features of Castleman’s disease. Histopathology. 1991;18:249–53.
Zarate-Osorno A, Medeiros LJ, Danon AD, Neiman RS. Hodgkin’s disease with coexistent Castleman-like histologic features. A report of three cases. Arch Pathol Lab Med. 1994;118:270–4.
Abdel-Reheim FA, Koss W, Rappaport ES, Arber DA. Coexistence of Hodgkin’s disease and giant lymph node hyperplasia of the plasma-cell type (Castleman’s disease). Arch Pathol Lab Med. 1996;120:91–6.
Drut R, Larregina A. Angiofollicular lymph node transformation in Hodgkin’s lymphoma. Pediatr Pathol. 1991;11:903–8.
Haque S, van Kirk R. Three patients with both Hodgkin’ lymphoma and Castleman’s disease: clinicopathologic correlations and lack of association with HHV-8. Indian J Med Paediatr Oncol. 2009;30:76–9.
McAloon EJ. Hodgkin’s disease in a patient with Castleman’s disease. N Engl J Med. 1985;313:758.
Molinie V, Diebold J, Perie G. Hodgkin’s disease associated with localized or multicentric Castleman’s disease. Arch Pathol Lab Med. 1995;119:201.
Saletti P, Ghielmini M, Scali G, Pedrinis E, Gueneau M, Cavalli F. Hodgkin’s and Castleman’s disease in a patient with systemic mastocytosis. Ann Hematol. 1999;78:97–100.
Doggett RS, Colby TV, Dorfman RF. Interfollicular Hodgkin’s disease. Am J Surg Pathol. 1983;7:145–9.
Hsu SM, Xie SS, Hsu PL, Waldron JA Jr. Interleukin-6, but not interleukin-4, is expressed by Reed–Sternberg cells in Hodgkin’s disease with or without histologic features of Castleman’s disease. Am J Pathol. 1992;141:129–38.
Zhou L, Ivanov II, Spolski R, Min R, Shenderov K, Eqawa T, et al. IL-6 programs T(H)-17 cell differentiation by promoting sequential engagement of the IL-21 and IL-23 pathways. Nat Immunol. 2007;8:967–74.
Kurzrock R, Redman J, Cabanillas F, Jones D, Rothberg J, Talpaz M. Serum interleukin 6 levels are elevated in lymphoma patients and correlate with survival in advanced Hodgkin’s disease and with B symptoms. Cancer Res. 1993;53:2118–22.
Gaiolla RD, Domingues MA, Niero-Melo L, de Oliveira DE. Serum levels of interleukins 6, 10, and 13 before and after treatment of classic Hodgkin lymphoma. Arch Pathol Lab Med. 2011;135:483–9.
Casasnovas RO, Mounier N, Brice P, Divine M, Morschhauser F, Gabarre J, et al. Plasma cytokine and soluble receptor signature predicts outcome of patients with classical Hodgkin’s lymphoma: a study from the Groupe d’Etude des Lymphomes de l’Adulte. J Clin Oncol. 2007;25:1732–40.