Lymphoplasmacytic infiltrate of regional lymph nodes in Kuttner's tumor (chronic sclerosing sialadenitis): a report of 3 cases

Int J Surg Pathol. 2008 Jul;16(3):263-8. doi: 10.1177/1066896907306969.

Abstract

Regional lymph nodes of Küttner's tumor from 3 patients showed reactive follicular hyperplasia and prominent interfollicular plasmacytosis. The patients were 71-, 57-, and 73-year-old Japanese men. The polytypic nature of plasma cells was demonstrated by immunohistochemistry. There were numerous IgG-positive plasma cells with scattered IgA-positive or IgM-positive plasma cells. IgG4-positive cells comprised 25% to 40% of IgG-positive plasma cells. Prominent polyclonal hyperimmunoglobulinemia was demonstrated on laboratory test in 2 cases examined. An elevated serum IgG4 level (16%) was also demonstrated in 1 patient. The present 3 cases indicated that regional lymph node of Küttner's tumor may show reactive follicular hyperplasia and prominent interfollicular plasmacytosis and should be differentiated from various benign and malignant lymphoproliferative disorders including systemic rheumatic disease, plasma cell type of Castleman disease, and lymph node involvement of marginal B-cell lymphoma of the mucosa-associated lymphoid tissue type showing prominent plasma cell differentiation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biomarkers / metabolism
  • Castleman Disease / diagnosis
  • Castleman Disease / immunology
  • Castleman Disease / pathology*
  • Diagnosis, Differential
  • Humans
  • Hypergammaglobulinemia / immunology
  • Hypergammaglobulinemia / metabolism
  • Hypergammaglobulinemia / pathology
  • Immunoglobulin G / metabolism
  • Lymph Nodes / immunology
  • Lymph Nodes / pathology*
  • Lymphoma, B-Cell, Marginal Zone / diagnosis
  • Male
  • Middle Aged
  • Plasma Cells / immunology
  • Plasma Cells / metabolism
  • Plasma Cells / pathology*
  • Rheumatic Diseases / diagnosis
  • Sclerosis
  • Sialadenitis / immunology
  • Sialadenitis / metabolism
  • Sialadenitis / pathology*
  • Submandibular Gland / immunology
  • Submandibular Gland / pathology*

Substances

  • Biomarkers
  • Immunoglobulin G