[Pathology] Atlas of Reactive, Developmental, Inflammatory, and Tumorlike Conditions (part 6)

[Pathology] Atlas of Reactive, Developmental, Inflammatory, and Tumorlike Conditions (part 6)

Continued of part 5: [Pathology] Atlas of Reactive, Developmental, Inflammatory, and Tumorlike Conditions (part 5)

Fig. 1.50 A dysplastic germinal center in Castleman’s disease shows

stromal hyalinization and concentric “onionskin” layering of mantle

lymphocytes; a tangentially sectioned blood vessel traversing the germinal center results in the so-called lollipop sign

Fig. 1.51 This view of another dysplastic follicle in Castleman’s disease shows 

multiple tangentially cut vessels traversing the follicle, with

extensive sclerosis and perivascular hyalinization of the germinal center  

Fig. 1.52 Another aspect of hyaline-vascular Castleman’s disease of

the mediastinum shows a dysplastic follicle in the center surrounded by

a hypervascular interfollicular zone composed of small vessels lined by

plump endothelial cells

Fig. 1.53 Higher magnification of the interfollicular region in

Castleman’s disease of the hyaline-vascular type shows prominent

hypervascularity with numerous, branching small vessels lined by

plump endothelial cells. The infiltrate is composed of small lymphocytes 

admixed with scattered eosinophils and plasma cells

Fig. 1.54 Abnormal follicle in hyaline-vascular type of Castleman’s

disease, showing two hyalinized germinal centers within the same follicle. 

Notice that the germinal centers are lymphocyte depleted, and one

of them shows a “lollipop” vessel traversing it from the interfollicular compartment

Fig. 1.55 Extensive interfollicular sclerosis and hyalinization in interfollicular 

areas in Castleman’s disease of the mediastinum, hyalinevascular type  

Fig. 1.56 Higher magnification of the germinal center in mediastinal

Castleman’s disease shows focal sclerosis and hyalinization in a small

vessel surrounded by epithelioid endothelial cells simulating a Hassall’s

corpuscle. On small biopsy samples, this appearance may be confused

with thymic hyperplasia or thymoma

Fig. 1.57 Mediastinal Castleman’s disease, plasma cell variant, showing a

small follicle (left) surrounded by a dense population of mature,
polytypic plasma cells  

Fig. 1.58 Higher magnification of mediastinal Castleman’s disease,

plasma cell type, shows a dysplastic lymphoid follicle with typical “lollipop” 

sign and concentric, onionskin arrangement of mantle lymphocytes

Fig. 1.59 Higher magnification of mediastinal Castleman’s disease,

plasma cell type, shows a dense population of mature plasma cells

admixed with small vessels  

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