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 language | English |
|---|---|
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | Medical Molecular Morphology |
| DOIs | |
| Publication status | Accepted/In press - Jul 20 2016 |
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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
Immunohistochemical analysis of IgA expression differentiates IgG4-related disease from plasma cell-type Castleman disease. / Manabe, Akihiro; Igawa, Takuro; Takeuchi, Mai; Gion, Yuka; Yoshino, Tadashi; Sato, Yasuharu.
In: Medical Molecular Morphology, 20.07.2016, p. 1-8.Research output: Contribution to journal › Article
}
TY - JOUR
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
KW - IgG4-related disease
KW - Immunohistochemistry
KW - Plasma cell type Castleman disease
UR - http://www.scopus.com/inward/record.url?scp=84979231042&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84979231042&partnerID=8YFLogxK
U2 - 10.1007/s00795-016-0145-4
DO - 10.1007/s00795-016-0145-4
M3 - Article
C2 - 27438709
AN - SCOPUS:84979231042
SP - 1
EP - 8
JO - Medical Electron Microscopy
JF - Medical Electron Microscopy
SN - 0918-4287
ER -