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Pathology AIIMS 2018 8e7413da

A patient presented with intermittent fever, no weight loss, no anorexia, but with a retroperitoneal mass. Peripheral smear findings were normal. Gross & microscopy of the mass is given. What's the diagnosis?

A
NHL
B
Castleman disease
C
Angiolymphoid hyperplasia
D
Ig G4 disease
High-Yield Explanation
Onion skin appearance of lymph node is characteristic for Castleman disease It is alympho proliferative disorder. It has 2 variants: Unicentric Has 2 variants: 1)Highly vasculara More common , patients are asymptomatic Histology: -Twinning- Presence of two germinal centers -Onion skin pattern-Lymphocytes causes thickening of mantle zone -Lollipop lesions- Sclerosed blood vessel that infiltrate lymph node germinal center Multicentric ?Associated with immune suppression ?Presents as : Hepatomegaly Splenomegaly Night sweats Fever 2)Plasma cell varianta Less common, patients are symptomatic: - Weight loss -Night sweats -Fever Histology: Plasma cells in interfollicular areas causing hyperplasia of germinal center Lymph node architecture is distoed but LN is preserved in unicentric variant

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