Multicentric angiofollicular lymph node hyperplasia (Castleman's disease) followed by Kaposís sarcoma in two homosexual males with the acquired immunodeficiency syndrome (AIDS)

• Published in: American journal of clinical pathology Vol. 83; no. 1; pp. 27 - 33
• Main Authors: LACHANT, N. A, SUN, N. C. J, LEONG, L. A, OSEAS, R. S, PRINCE, H. E
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Society of Clinical Pathologists 1985
• Subjects: Acquired Immunodeficiency Syndrome - complications; Acquired Immunodeficiency Syndrome - immunology; Adult; AIDS/HIV; Biological and medical sciences; Homosexuality; Humans; Hyperplasia - etiology; Hyperplasia - immunology; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Killer Cells, Natural - physiology; Lymph Nodes - pathology; Male; Medical sciences; Rosette Formation; Sarcoma, Kaposi - etiology; Sarcoma, Kaposi - immunology; T-Lymphocytes - classification; Human; Homosexuality; Skin disease; Multiple; AIDS; Hemopathy; Infection; Pathology; Kaposi sarcoma; Adenopathy; Viral disease; Castleman lymphoma; Venereal disease
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1093/ajcp/83.1.27

Two homosexual men with the acquired immunodeficiency syndrome (AIDS) who developed a multicentric variant of angiofollicular lymph node hyperplasia (AFLNH) (Castleman's disease) and Kaposi's sarcoma are reported. Both had diffuse adenopathy, splenomegaly, and a systemic inflammatory state. Both had an absolute increase in Leu 1+ lymphocytes, which was associated with markedly decreased Leu 3+ lymphocytes, markedly increased Leu-2+ lymphocytes, and a very low Leu 3/2 ratio. The lymphocytes of both patients had a normal blastogenic response to PHA. The lymphocytes of patient 1 had a poor response to autologous or allogenic cells in the mixed lymphocyte culture reaction. AFLNH represents another lymphoreticular complication of AIDS. Given the interrelationships between AFLNH, the development of Kaposi's sarcoma, and the aggressive clinical course seen in our two patients and those in the literature, the aggressive use of lymph node biopsy may be an important prognostic tool for the patient with the acquired immunodeficiency syndrome.