Immunohistochemical analysis of IgA expression differentiates IgG4-related disease from plasma cell-type Castleman disease

Akihiro Manabe, Takuro Igawa, Mai Takeuchi, Yuka Gion, Tadashi Yoshino, Yasuharu Sato

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5 Citations (Scopus)

Abstract

Plasma cell-type Castleman disease (PCD) is often encountered when differentiating IgG4-related disease (IgG4-RD). Given that serum IgA is often elevated in Castleman disease, we investigated whether IgA expression levels in histological specimens can be used to differentiate between the two diseases. Lymph node lesions obtained from 12 IgG4-RD and 11 PCD patients were analysed by immunohistochemistry with anti-IgG, -IgG4, and -IgA antibodies. In addition to all 12 cases of IgG4-RD, 8/11 cases (72.7 %) of PCD also met the diagnostic criteria of IgG4-RD (serum IgG4 ≥135 mg/dl and IgG4/IgG-positive cells ≥40 %). IgA-positive cells were sparsely and densely distributed in IgG4-RD and PCD cases, respectively. The median number of IgA-positive cells ± SD in all 12 cases of IgG4-RD was 31 ± 37 cells per three high-powered fields (3HPFs) (range 4–118 cells/3HPFs). In contrast, the median number of IgA-positive cells, which was significantly higher in all 11 cases of PCD, was 303 ± 238 cells/3HPFs (range 74–737 cells/3HPFs) (P <0.001). In conclusion, our findings indicate that in cases where serum analysis-based data are unavailable, anti-IgA immunostaining can be used for differential diagnosis of IgG4-RD.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalMedical Molecular Morphology
DOIs
Publication statusAccepted/In press - Jul 20 2016

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Giant Lymph Node Hyperplasia
Plasma Cells
Immunoglobulin A
Immunoglobulin G
Serum
Differential Diagnosis
Lymph Nodes
Immunohistochemistry

Keywords

  • Hyper IL-6 syndrome
  • IgG4
  • IgG4-related disease
  • Immunohistochemistry
  • Plasma cell type Castleman disease

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Molecular Biology

Cite this

@article{59fc453e268a41d78f2fea2e712d7259,
title = "Immunohistochemical analysis of IgA expression differentiates IgG4-related disease from plasma cell-type Castleman disease",
abstract = "Plasma cell-type Castleman disease (PCD) is often encountered when differentiating IgG4-related disease (IgG4-RD). Given that serum IgA is often elevated in Castleman disease, we investigated whether IgA expression levels in histological specimens can be used to differentiate between the two diseases. Lymph node lesions obtained from 12 IgG4-RD and 11 PCD patients were analysed by immunohistochemistry with anti-IgG, -IgG4, and -IgA antibodies. In addition to all 12 cases of IgG4-RD, 8/11 cases (72.7 {\%}) of PCD also met the diagnostic criteria of IgG4-RD (serum IgG4 ≥135 mg/dl and IgG4/IgG-positive cells ≥40 {\%}). IgA-positive cells were sparsely and densely distributed in IgG4-RD and PCD cases, respectively. The median number of IgA-positive cells ± SD in all 12 cases of IgG4-RD was 31 ± 37 cells per three high-powered fields (3HPFs) (range 4–118 cells/3HPFs). In contrast, the median number of IgA-positive cells, which was significantly higher in all 11 cases of PCD, was 303 ± 238 cells/3HPFs (range 74–737 cells/3HPFs) (P <0.001). In conclusion, our findings indicate that in cases where serum analysis-based data are unavailable, anti-IgA immunostaining can be used for differential diagnosis of IgG4-RD.",
keywords = "Hyper IL-6 syndrome, IgG4, IgG4-related disease, Immunohistochemistry, Plasma cell type Castleman disease",
author = "Akihiro Manabe and Takuro Igawa and Mai Takeuchi and Yuka Gion and Tadashi Yoshino and Yasuharu Sato",
year = "2016",
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T1 - Immunohistochemical analysis of IgA expression differentiates IgG4-related disease from plasma cell-type Castleman disease

AU - Manabe, Akihiro

AU - Igawa, Takuro

AU - Takeuchi, Mai

AU - Gion, Yuka

AU - Yoshino, Tadashi

AU - Sato, Yasuharu

PY - 2016/7/20

Y1 - 2016/7/20

N2 - Plasma cell-type Castleman disease (PCD) is often encountered when differentiating IgG4-related disease (IgG4-RD). Given that serum IgA is often elevated in Castleman disease, we investigated whether IgA expression levels in histological specimens can be used to differentiate between the two diseases. Lymph node lesions obtained from 12 IgG4-RD and 11 PCD patients were analysed by immunohistochemistry with anti-IgG, -IgG4, and -IgA antibodies. In addition to all 12 cases of IgG4-RD, 8/11 cases (72.7 %) of PCD also met the diagnostic criteria of IgG4-RD (serum IgG4 ≥135 mg/dl and IgG4/IgG-positive cells ≥40 %). IgA-positive cells were sparsely and densely distributed in IgG4-RD and PCD cases, respectively. The median number of IgA-positive cells ± SD in all 12 cases of IgG4-RD was 31 ± 37 cells per three high-powered fields (3HPFs) (range 4–118 cells/3HPFs). In contrast, the median number of IgA-positive cells, which was significantly higher in all 11 cases of PCD, was 303 ± 238 cells/3HPFs (range 74–737 cells/3HPFs) (P <0.001). In conclusion, our findings indicate that in cases where serum analysis-based data are unavailable, anti-IgA immunostaining can be used for differential diagnosis of IgG4-RD.

AB - Plasma cell-type Castleman disease (PCD) is often encountered when differentiating IgG4-related disease (IgG4-RD). Given that serum IgA is often elevated in Castleman disease, we investigated whether IgA expression levels in histological specimens can be used to differentiate between the two diseases. Lymph node lesions obtained from 12 IgG4-RD and 11 PCD patients were analysed by immunohistochemistry with anti-IgG, -IgG4, and -IgA antibodies. In addition to all 12 cases of IgG4-RD, 8/11 cases (72.7 %) of PCD also met the diagnostic criteria of IgG4-RD (serum IgG4 ≥135 mg/dl and IgG4/IgG-positive cells ≥40 %). IgA-positive cells were sparsely and densely distributed in IgG4-RD and PCD cases, respectively. The median number of IgA-positive cells ± SD in all 12 cases of IgG4-RD was 31 ± 37 cells per three high-powered fields (3HPFs) (range 4–118 cells/3HPFs). In contrast, the median number of IgA-positive cells, which was significantly higher in all 11 cases of PCD, was 303 ± 238 cells/3HPFs (range 74–737 cells/3HPFs) (P <0.001). In conclusion, our findings indicate that in cases where serum analysis-based data are unavailable, anti-IgA immunostaining can be used for differential diagnosis of IgG4-RD.

KW - Hyper IL-6 syndrome

KW - IgG4

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KW - Immunohistochemistry

KW - Plasma cell type Castleman disease

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