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Pulmonary Manifestations of Plasma Cell Type Idiopathic Multicentric Castleman Disease: A Clinicopathological Study in Comparison with IgG4-Related Disease

Plasma cell type idiopathic multicentric Castleman disease (PC-iMCD) occasionally manifests as parenchymal lung disease. This study aimed to elucidate the detailed clinicopathological features of lung lesions in PC-iMCD and compare the findings with those in immunoglobulin (Ig) G4-related disease (I...

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Autores principales: Nishimura, Midori Filiz, Igawa, Takuro, Gion, Yuka, Tomita, Sakura, Inoue, Dai, Izumozaki, Akira, Ubara, Yoshifumi, Nishimura, Yoshito, Yoshino, Tadashi, Sato, Yasuharu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768369/
https://www.ncbi.nlm.nih.gov/pubmed/33321725
http://dx.doi.org/10.3390/jpm10040269
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author Nishimura, Midori Filiz
Igawa, Takuro
Gion, Yuka
Tomita, Sakura
Inoue, Dai
Izumozaki, Akira
Ubara, Yoshifumi
Nishimura, Yoshito
Yoshino, Tadashi
Sato, Yasuharu
author_facet Nishimura, Midori Filiz
Igawa, Takuro
Gion, Yuka
Tomita, Sakura
Inoue, Dai
Izumozaki, Akira
Ubara, Yoshifumi
Nishimura, Yoshito
Yoshino, Tadashi
Sato, Yasuharu
author_sort Nishimura, Midori Filiz
collection PubMed
description Plasma cell type idiopathic multicentric Castleman disease (PC-iMCD) occasionally manifests as parenchymal lung disease. This study aimed to elucidate the detailed clinicopathological features of lung lesions in PC-iMCD and compare the findings with those in immunoglobulin (Ig) G4-related disease (IgG4-RD), the most difficult differential diagnosis of PC-iMCD. We analyzed the clinicopathological findings and immunohistochemical expression patterns of interleukin-6 (IL-6) and Igs in lung specimens from 16 patients with PC-iMCD and 7 patients with IgG4-RD. Histologically, pulmonary PC-iMCD could not be differentiated from IgG4-RD based on lesion distribution patterns, the number of lymphoid follicles and obliterative vasculitis, or fibrosis types. The eosinophil count was higher in the IgG4-RD group than in the PC-iMCD group (p = 0.004). The IgG4/IgG-positive cell ratio was significantly higher in the IgG4-RD group (p < 0.001). The IgA-positive cell count and IL-6 expression intensity were higher in the PC-iMCD group than in the IgG4-RD group (p < 0.001). Based on these findings, we proposed a new diagnostic approach to differentiate lung lesions of PC-iMCD and IgG4-RD. Our approach can be utilized to stratify patients with suspected lung-dominant PC-iMCD to identify candidates for strong immunosuppressive treatment, including IL-6 blockade, at an early stage.
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spelling pubmed-77683692020-12-29 Pulmonary Manifestations of Plasma Cell Type Idiopathic Multicentric Castleman Disease: A Clinicopathological Study in Comparison with IgG4-Related Disease Nishimura, Midori Filiz Igawa, Takuro Gion, Yuka Tomita, Sakura Inoue, Dai Izumozaki, Akira Ubara, Yoshifumi Nishimura, Yoshito Yoshino, Tadashi Sato, Yasuharu J Pers Med Article Plasma cell type idiopathic multicentric Castleman disease (PC-iMCD) occasionally manifests as parenchymal lung disease. This study aimed to elucidate the detailed clinicopathological features of lung lesions in PC-iMCD and compare the findings with those in immunoglobulin (Ig) G4-related disease (IgG4-RD), the most difficult differential diagnosis of PC-iMCD. We analyzed the clinicopathological findings and immunohistochemical expression patterns of interleukin-6 (IL-6) and Igs in lung specimens from 16 patients with PC-iMCD and 7 patients with IgG4-RD. Histologically, pulmonary PC-iMCD could not be differentiated from IgG4-RD based on lesion distribution patterns, the number of lymphoid follicles and obliterative vasculitis, or fibrosis types. The eosinophil count was higher in the IgG4-RD group than in the PC-iMCD group (p = 0.004). The IgG4/IgG-positive cell ratio was significantly higher in the IgG4-RD group (p < 0.001). The IgA-positive cell count and IL-6 expression intensity were higher in the PC-iMCD group than in the IgG4-RD group (p < 0.001). Based on these findings, we proposed a new diagnostic approach to differentiate lung lesions of PC-iMCD and IgG4-RD. Our approach can be utilized to stratify patients with suspected lung-dominant PC-iMCD to identify candidates for strong immunosuppressive treatment, including IL-6 blockade, at an early stage. MDPI 2020-12-10 /pmc/articles/PMC7768369/ /pubmed/33321725 http://dx.doi.org/10.3390/jpm10040269 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Nishimura, Midori Filiz
Igawa, Takuro
Gion, Yuka
Tomita, Sakura
Inoue, Dai
Izumozaki, Akira
Ubara, Yoshifumi
Nishimura, Yoshito
Yoshino, Tadashi
Sato, Yasuharu
Pulmonary Manifestations of Plasma Cell Type Idiopathic Multicentric Castleman Disease: A Clinicopathological Study in Comparison with IgG4-Related Disease
title Pulmonary Manifestations of Plasma Cell Type Idiopathic Multicentric Castleman Disease: A Clinicopathological Study in Comparison with IgG4-Related Disease
title_full Pulmonary Manifestations of Plasma Cell Type Idiopathic Multicentric Castleman Disease: A Clinicopathological Study in Comparison with IgG4-Related Disease
title_fullStr Pulmonary Manifestations of Plasma Cell Type Idiopathic Multicentric Castleman Disease: A Clinicopathological Study in Comparison with IgG4-Related Disease
title_full_unstemmed Pulmonary Manifestations of Plasma Cell Type Idiopathic Multicentric Castleman Disease: A Clinicopathological Study in Comparison with IgG4-Related Disease
title_short Pulmonary Manifestations of Plasma Cell Type Idiopathic Multicentric Castleman Disease: A Clinicopathological Study in Comparison with IgG4-Related Disease
title_sort pulmonary manifestations of plasma cell type idiopathic multicentric castleman disease: a clinicopathological study in comparison with igg4-related disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768369/
https://www.ncbi.nlm.nih.gov/pubmed/33321725
http://dx.doi.org/10.3390/jpm10040269
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