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Castleman's disease with renal infiltration by polyclonal plasma cells
O Frøkjaer Thomsen1, J Ladefoged
1Department of Pathology, University of Copenhagen, Rigshospitalet, Denmark.
Clinical Nephrology
|June 9, 1998
Summary
Castleman's disease, a lymph node disorder, can rarely cause kidney problems. This case highlights its potential to infiltrate the renal interstitium with plasma cells, impacting kidney function.
Area of Science:
- Nephrology
- Hematology
- Pathology
Background:
- Castleman's disease (angiofollicular lymph node hyperplasia) is a rare lymphoproliferative disorder.
- Renal involvement is an uncommon but recognized complication of Castleman's disease.
Observation:
- A 52-year-old male presented with declining renal function.
- Previous mediastinal lymph node biopsy confirmed Castleman's disease.
- Current renal biopsy revealed massive interstitial infiltration by plasma cells.
Findings:
- Immunostaining of renal plasma cells showed positivity for IgG and kappa/lambda light chains, consistent with the mediastinal lymph node findings.
- The renal findings were interpreted as direct interstitial involvement by Castleman's disease.
- Treatment with prednisone stabilized but did not improve renal function.
Implications:
- Castleman's disease should be considered in the differential diagnosis of unexplained renal interstitial cellular infiltration.
- This case underscores the importance of considering systemic conditions in the evaluation of renal pathology.
- Further research into the mechanisms and management of renal involvement in Castleman's disease is warranted.
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