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A novel approach for characterization of KSHV-associated multicentric Castleman disease from effusions.

Ting ZhouConstance M YuanKathryn LurainClarissa RousLinda WeaverMark RaffeldMaryalice Stetler-StevensonThomas S UldrickArmando C FilieStefania PittalugaElaine S JaffeVickie MarshallKyle MooreDenise WhitbyRamya RamaswamiRobert YarchoanHao-Wei Wang
Published in: British journal of haematology (2022)
A biopsy of lymphoid tissue is currently required to diagnose Kaposi sarcoma-associated herpesvirus (KSHV)-associated multicentric Castleman disease (KSHV-MCD). Patients showing clinical manifestations of KSHV-MCD but no pathological changes of KSHV-MCD are diagnosed as KSHV inflammatory cytokine syndrome. However, a lymph node biopsy is not always feasible to make the distinction. A pathognomonic feature of lymph nodes in KSHV-MCD is the expansion of KSHV-infected, lambda-restricted but polyclonal plasmablasts. To investigate whether these cells also reside in extra-nodal sites, effusion from 11 patients with KSHV-MCD and 19 with KSHV inflammatory cytokine syndrome was analysed by multiparametric flow cytometry. A distinct, lambda-restricted plasmablastic population (LRP) with highly consistent immunophenotype was detected in effusions in 8/11 patients with KSHV-MCD. The same population was also observed in 7/19 patients with KSHV inflammatory cytokine syndrome. The detection of LRP stratified KSHV inflammatory cytokine syndrome into two clinically distinct subgroups; those with detectable LRP closely resembled KSHV-MCD, showing similar KSHV viral load, comparable severity of thrombocytopenia and hypoalbuminaemia, and similar incidences of hepatosplenomegaly. Collectively, the detection of LRP by flow cytometry can serve as a valuable tool in diagnosing KSHV-MCD. KSHV inflammatory cytokine syndrome with LRP in effusions may represent a liquid-form of KSHV-MCD.
Keyphrases
  • lymph node
  • flow cytometry
  • oxidative stress
  • squamous cell carcinoma
  • early stage
  • signaling pathway
  • cell proliferation
  • prognostic factors
  • ejection fraction
  • ionic liquid
  • rectal cancer
  • low density lipoprotein