Immunological markers and DNA content in a case of giant lymph node hyperplasia (Castleman's disease)

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Abstract
Little is known about the immunologic characteristics of the cells in giant lymph node hyperplasia (GLNH). For this reason, cell surface markers and intracytoplasmic immunoglobulins were determined on a case of GLNH. In addition, cellular DNA content was determined by flow analysis. A 59-year-old male underwent thoracotomy for a posterior madiastinal mass, which was entirely excised. Histologically, the mass was diagnosed as GLNH with features of both the hyaline-vascular and plasma-cell types. Preoperatively, the patient had a broad-based hypergammaglobulinemia with an increase in serum IgG. Two months postoperatively, the serum protein electrophoresis had returned to normal. Surface immunoglobulins (SIg) were determined on fresh cells in suspension using a polyvalent antiserum and monospecific antisera against heavy and light chains. Ten percent of the cells had SIg. The distribution of SIg-bearing cells was polyclonal. Intracytoplasmic immunoglobulin (CIg), as determined by immunofluorescence on ethanol-fixed smears from the cell suspensions, showed 6% positive cells. The distribution of cytoplasmic immunoglobulin was similarly polyclonal. Ethanol-fixed frozen sections also showed a polyclonal pattern when stained for CIg. Fifty-two percent of fresh cells in suspension formed Erosettes. These immunologic characteristics do not differ from those observed in non-neoplastic lymphoid tissues. A DNA content histogram was obtained by flow microfluorometry using ethanol-fixed cells stained with propidium iodide following RNase treatment. The DNA content distribution was within the normal limits established by the study of non-neoplastic lymphoid tissues.