PMC6609882_01
Mixed histopathological subtype of Castleman disease. (A) Follicles are characterized by an atrophic germinal center with few lymphocytes, radially penetrated by blood vessels (lollipop follicle). HES 100x (B) the small lymphocytes of the mantle zones are arranged in concentric rings around the germinal center. Silver impregnation after Gordon-Sweet 100x.
fimmu-10-01489-g0001.jpg
PMC6609882_01_fimmu-10-01489-g0001.jpg
F1
A cervical lymph node biopsy found features consistent with the mixed histopathological subtype of iMCD (Figure 1).
Representative photomicrographs from kidney biopsy of the case: membranoproliferative glomerulonephritis pattern. (A) Increased lobulation with intracapillary hypercellularity by macrophages and neutrophils. Masson's Trichrome 400x. (B) Thickening of capillary due to multiple double contours. Mild mesangial proliferation. Silver impregnation after Jones 400x. Mild. (C) Segmentary granular capillary walls deposits for IgM. Immunofluorescence (IF) 400x. (D) Mild endomembranous deposits for Lambda light chains. IF 400x. (E) Mild endomembranous deposits for Kappa light chains. IF 400x. (F) Ultrastructural study showed moderate subendothelial dense deposits without subepithelial neither intra-membranous deposits x1293.
fimmu-10-01489-g0002.jpg
PMC6609882_01_fimmu-10-01489-g0002.jpg
F2
A renal biopsy revealed 32 glomeruli a MPGN pattern was observed with endocapillary proliferation (macrophages and neutrophils), mild mesangial proliferation, mesangiolysis, endothelial cell swelling and thickening of capillaries due to multiple double contours (light microscopy) (Figure 2).