Unicentric mixed variant castleman disease associated with intrabronchial plasmacytoma.

Castleman disease (CD), described as a heterogeneous lymphoproliferative disorder, can be divided into different subtypes according to clinical appearance (unicentric and multicentric form) and histopathological features (hyaline vascular, plasma cell, mixed type, human herpesvirus 8-associated and multicentric not otherwise specified). Unicentric CD is known to be usually of the hyaline vascular variant, plasma cell and mixed type of this form are quite uncommon. Malignancies are mainly associated with the multicentric form. We report a rare case of unicentric mixed variant CD evolving into intrabronchial, extramedullary plasmacytoma.Intrabronchial mass with consequential obstruction of the left main bronchus, left lung atelectasis and mediastinal lymphadenomegaly was detected by chest CT in our patient suffering from cough and hemoptysis. Pulmonectomy was performed, histopathological and immunhistochemical analysis of lymph nodes revealed mixed type of CD with interfollicular monotypic plasma cell proliferation. The intrabronchial mass consisted of monotypic plasma cells confirming plasmacytoma. Systemic involvement was not confirmed by further tests.Although malignancies more often present in multicentric CD that usually belongs to the plasma cell subtype, this case confirms the neoplastic potential of the rarest, unicentric mixed variant of CD.Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2872096831190851

Surgical treatment of primitive gastro-intestinal lymphomas: a systematic review

Primitive Gastrointestinal Lymphomas (PGIL) are uncommon tumours, although time-trend analyses have demonstrated an increase. The role of surgery in the management of lymphoproliferative diseases has changed over the past 40 years. Nowadays their management is centred on systemic treatments as chemo-/radio- therapy. Surgery is restricted to very selected indications, always discussed in a multidisciplinary setting. The aim of this systematic review is to evaluate the actual role of surgery in the treatment of PGIL

Chronic progressive polyarthritis and other symptoms of collagen vascular disease induced by graft-vs-host reaction

The induction of a GVHR in (BALB/c X A)F1 mice by i.v. injection of 80 to 120 X 10(6) BALB/c spleen cells leads to the development of chronic progressive polyarthritis, which shares several of the articular and extra-articular manifestations of human rheumatoid arthritis. The development of these lesions was found to be mediated by donor T cells and to require the presence of histoincompatibility between donor and host. The arthritis, which was mainly confined to the interphalangeal joints of the forefeet and hindfeet, was histologically characterized by periarticular and synovial lymphoid infiltrations, as well as synovial proliferation and pannus formation. Prominent juxta-articular lesions included 1) perivascular infiltrates, 2) peritendinitis, 3) myositis, and 4) inflammatory nodules. In addition, the GVH F1 mice showed pathologic symptoms reminiscent of other collagen vascular diseases, including the following: 1) a Sjögren-like salivary gland lesion, 2) lesions resembling sclerosing cholangitis, 3) scleroderma-like skin lesion, and 4) immune-complex glomerulonephritis. In most of the GVH F1 mice, these pathologic changes were accompanied by lymphoid stimulation. The spectrum of symptoms induced has many similarities to that found in mixed connective tissue diseas