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Dupin N, Diss TL, Kellam P, et al. HHV-8 is associated with a plasmablastic variant of Castleman disease that is linked to HHV-8-positive plasmablastic lymphoma

Departments of Oncology, Molecular Pathology and Histopathology, University College London, UK.
Blood (Impact Factor: 10.43). 03/2000; 95(4):1406-12.
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ABSTRACT Castleman disease (CD) is a lymphoproliferative disorder of unknown etiology that is associated with the development of secondary tumors, including B-cell lymphoma. Human herpesvirus 8 (HHV-8) (Kaposi's sarcoma-associated herpesvirus) sequences have been described in some cases of multicentric Castleman disease (MCD). Using a monoclonal antibody against an HHV-8-latent nuclear antigen, we show that HHV-8 is specifically associated with a variant of MCD in which HHV-8-positive plasmablasts that show lambda light-chain restriction localize in the mantle zone of B-cell follicles and coalesce to form microscopic lymphomas in some cases. Furthermore, we show that the frank plasmablastic lymphoma that develops in patients with this plasmablastic variant of MCD is also positive for HHV-8 and lambda light chain. Plasmablastic lymphoma associated with MCD is a new disease entity associated with HHV-8 infection. (Blood. 2000;95:1406-1412)

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    • "Of the 8 HIV-positive patients with MCD, 5 (62.5%) of them also had Kaposi’s sarcoma. Of the patients with HIV infection and MCD HHV-8, 4 (50%) eventually developed a plasmablastic lymphoma and 1 developed a hematological blast crisis 6 months after the diagnosis of MCD.9 Oksenhendler et al.10 presented a cohort study of Kaposi sarcoma-associated herpes virus-related non-Hodgkin lymphoma in patients with HIV infection and multicentric Castleman’s disease. In this study of HIV-infected patients with MCD, the incidence of NHL was 15-fold higher than that observed in the general HIV-1 infected population. "
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    ABSTRACT: Castleman's disease is a group of rare lymphoproliferative disorders. The plasmablastic multicentric Castleman's disease is frequently discovered in HIV-infected individuals in association with Kaposi sarcoma (HHV-8). Thirty-five year old male presented to our care with the main compliant of severe back pain for one week. His past medical problems include acquired immune deficiency syndrome diagnosed 12 years prior and Kaposi sarcoma, currently on highly active antiretroviral therapy (HAART). Radiographic imaging revealed hepatomegaly and diffuse lymphadenopathy. The HIV viral load was <20 polymerase chain reaction copies/mL, absolute CD4 count was 453 cells/mcL (490-1740 cells/mcL) and CD8 count was 4142 cells/mcL (180-1170 cells/ mcL). Excisional biopsy of the left supraclavicular lymph node was performed with pathological findings of HHV8+ Kaposi sarcoma in the background of multicentric Castleman's disease (plasmacytic variant). No evidence of transformation into large B-cell or plasmablastic lymphoma was noted. He was discharged on HAART and follow up to receive chemotherapy with cyclophosphamide, adriamycin, vincristine plus prednisone was started and rituximab plus prophylaxis for pneumocystis carinii. Multicentric Castleman's disease has become more relevant in recent years due to its association with HIV and HHV-8 (Kaposi sarcoma) and its potential to progress into plasmablastic B-cell lymphoma. The progression of MCD to B-cell lymphoma is a concern, especially in patients with HIV infection because it precludes the worst outcome and a high mortality, despite treatment. The most intriguing part of this case is that MCD occurred in a HIV-positive on HAART. This case signals a warning that a high suspicion for MCD can be justified even in those HIV-positive patients on HAART because the possibly of progression to plasmablastic B-cell lymphoma.
    Rare tumors 07/2014; 6(3):5480. DOI:10.4081/rt.2014.5480
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    • "Cette maladie atteint plutôt des adultes jeunes asymptomatiques et la localisation est unique. En raison d'une certaine analogie histologique, le nom de MDC a été repris pour décrire : • une maladie multicentrique associée à une possible atteinte viscérale et à des signes généraux chez le patient âgé [2] et ; • une forme agressive de la maladie associée au virus du SIDA et en rapport avec une co-infection HHV-8 [3]. "
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    ABSTRACT: Castleman disease is a rare lymph nodes disease whose name covers different clinical presentations. The most frequent histology is the hyaline vascular localized form. In this case, Castleman disease occurs in young adults, and is localized to the mediastinum in one third of the cases. The disease is often asymptomatic, but paraneoplasic pemphigus has been described. The management of this form of Castleman disease is based on complete surgical resection. Perioperative immunomodulating treatments may be discussed in case of paraneoplasic pemphigus, mostly when affecting the bronchial tree.
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    • "While its routes of transmission are not completely understood, important known routes are sexual transmission, saliva, blood or organ transplantation [139]. In addition to KS, KSHV has been associated with lymphoproliferative disorders, including multicentric Castleman’s disease (MCD), plasmablastic lymphoma, and primary effusion lymphoma (PEL) [140]. "
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