[Pathology] Atlas of Reactive, Developmental, Inflammatory, and Tumorlike Conditions (part 6)

[Pathology] Atlas of Reactive, Developmental, Inflammatory, and Tumorlike Conditions (part 6)


Continued of part 5: [Pathology] Atlas of Reactive, Developmental, Inflammatory, and Tumorlike Conditions (part 5)

Fig. 1.50 A dysplastic germinal center in Castleman’s disease shows
stromal hyalinization and concentric “onionskin” layering of mantle
lymphocytes; a tangentially sectioned blood vessel traversing the germinal center results in the so-called lollipop sign

Fig. 1.51 This view of another dysplastic follicle in Castleman’s disease shows 
multiple tangentially cut vessels traversing the follicle, with
extensive sclerosis and perivascular hyalinization of the germinal center  


Fig. 1.52 Another aspect of hyaline-vascular Castleman’s disease of
the mediastinum shows a dysplastic follicle in the center surrounded by
a hypervascular interfollicular zone composed of small vessels lined by
plump endothelial cells

Fig. 1.53 Higher magnification of the interfollicular region in
Castleman’s disease of the hyaline-vascular type shows prominent
hypervascularity with numerous, branching small vessels lined by
plump endothelial cells. The infiltrate is composed of small lymphocytes 
admixed with scattered eosinophils and plasma cells

Fig. 1.54 Abnormal follicle in hyaline-vascular type of Castleman’s
disease, showing two hyalinized germinal centers within the same follicle. 
Notice that the germinal centers are lymphocyte depleted, and one
of them shows a “lollipop” vessel traversing it from the interfollicular compartment

Fig. 1.55 Extensive interfollicular sclerosis and hyalinization in interfollicular 
areas in Castleman’s disease of the mediastinum, hyalinevascular type  

Fig. 1.56 Higher magnification of the germinal center in mediastinal
Castleman’s disease shows focal sclerosis and hyalinization in a small
vessel surrounded by epithelioid endothelial cells simulating a Hassall’s
corpuscle. On small biopsy samples, this appearance may be confused
with thymic hyperplasia or thymoma

Fig. 1.57 Mediastinal Castleman’s disease, plasma cell variant, showing a
small follicle (left) surrounded by a dense population of mature,
polytypic plasma cells
  

Fig. 1.58 Higher magnification of mediastinal Castleman’s disease,
plasma cell type, shows a dysplastic lymphoid follicle with typical “lollipop” 
sign and concentric, onionskin arrangement of mantle lymphocytes

Fig. 1.59 Higher magnification of mediastinal Castleman’s disease,
plasma cell type, shows a dense population of mature plasma cells
admixed with small vessels  


Suggested Reading

Aw D, Palmer DB. The origin and implication of thymic involution. Aging Dis. 2011;2:437–43.

Benton C, Gerard P. Thymolipoma in a patient with Grave’s disease. J Thorac Surg. 1966;51:428–32.

Cohen AJ, Thompson I, Edwards FH, Bellamy RF. Primary cysts and tumors of the mediastinum. Ann Thorac Surg. 1991;51:378–86.

Craddock DR, Peacock MJ, Allen PW. Giant lymph node hyperplasia of the mediastinum. Med J Aust. 1974;18:795–7.

De Giacomo T, Diso D, Anile M, Venuta F, Rolla M, Ricella C, et al. Thoracoscopic resection of mediastinal bronchogenic cysts in adults. Eur J Cardiothorac Surg. 2009;36:357–9.

De Montpreville VT, Dulmet EM, Nashashibi N. Frozen section diagnosis and surgical biopsy of lymph nodes, tumors and pseudotumors of the mediastinum. Eur J Cardiothorac Surg. 1998;13:190–5.

Den Bakker MA, Oosterhuis JW. Tumors and tumor-like conditions of the thymus other than thymoma: a practical approach. Histopathology. 2009;54:69–89.

Dominguez-Malagon H, Guerrero-Medrano J, Suster S. Ectopic poorlydifferentiated (insular) carcinoma of the thyroid. Report of a case presenting as an anterior mediastinal mass. Am J Clin Pathol. 1995;104:408–12.

Flieder DB, Suster S, Moran CA. Idiopathic fibroinfl ammatory (fi brosing/sclerosing) lesions of the mediastinum. A study of 30 cases with emphasis on morphologic heterogeneity. Mod Pathol. 1999;12:257–64.

Gui J, Mustachio LM, Su DM, Craig RW. Thymus size and age-related thymic involution. Aging Dis. 2012;3:280–90. Hajhosseini B, Montazeri V, Hajhosseini L, Nezami N, Beygui

RE. Mediastinal goiter: a comprehensive study of 60 consecutive cases with special emphasis on identifying predictors of malignancy and sternotomy. Am J Surg. 2012;203:442–7.

Keller AR, Hochholzer L, Castleman B. Hyaline-vascular and plasma cell types of giant lymph node hyperplasia of the mediastinum and other locations. Cancer. 1972;29:670–83.

Le Marc’hadour F, Pinel N, Pasquier B, Dieny A, Stoebner P, Couderc P. Thymolipoma in association with myasthenia gravis. Am J Surg Pathol. 1991;15:802–9.

Mathisen DJ, Grillo HC. Clinical manifestations of mediastinal fibrosis and histoplasmosis. Ann Thorac Surg. 1992;54:1053–8.

Moran CA, Suster S. Primary parathyroid tumors of the mediastinum: a clinicopathologic and immunohistochemical study of 17 cases. Am J Clin Pathol. 2005;124:1–5.

Moran CA, Zeren H, Koss MN. Thymofi brolipoma: a variant of thymolipoma. Arch Pathol Lab Med. 1994;118:281–2.

Moran CA, Rosado de Christensen M, Suster S. Thymolipoma: clinicopathologic review of 33 cases. Mod Pathol. 1995;8:741–4.

Noussios G, Anagnostis P, Natsis K. Ectopic parathyroid glands and their anatomical, clinical and surgical implications. Exp Clin Endocrinol Diabetes. 2012;120:604–10.

Payne WS, Larson RH. Acute mediastinitis. Surg Clin N Am. 1969; 49:999–1009.

Schowengerdt XG, Suyemoto R, Main FB. Granulomatous and fibrous mediastinitis: a review and analysis of 180 cases. J Thorac Cardiovasc Surg. 1969;57:365–79.

Sirivella S, Ford WB, Zikria EA, Miller WH, Samadani SR, Sullivan ME. Foregut cysts of the mediastinum. Results in 20 consecutively surgically treated cases. J Thorac Cardiovasc Surg. 1985;90:776–82.

Suster S, Rosai J. Multilocular thymic cysts: an acquired reactive process. Study of 18 cases. Am J Surg Pathol. 1991;15:388–98.

Suster S, Rosai J. The thymus. In: Mills SE, editor. Histology for pathologists. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 505–25.

Suster S, Barbuto D, Carlson G, Rosai J. Multilocular thymic cysts with pseudoepitheliomatous hyperplasia. Hum Pathol. 1991;22:455–60.

Wakely Jr PE. Cytopathology-histopathology of the mediastinum: epithelial, lymphoproliferative, and germ cell neoplasms. Ann Diagn Pathol. 2002;6:30–43.


This is only a part of the book : Atlas of Mediastinal Pathology  of authors: Saul Suster. If you want to view the full content of the book and support author. Please buy it here: https://www.amazon.com/Atlas-Mediastinal-Pathology-Anatomic/dp/149392673X

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CLINICAL ATLAS,118,DERMATOLOGY ATLAS,10,EMERGENCY ATLAS,44,HAEMATOLOGY ATLAS,23,HUMAN ANATOMY,1,MICROBIOLOGY ATLAS,66,PARASITOLOGY ATLAS,4,PATHOLOGY ATLAS,22,PEDIATRIC ATLAS,42,STDs,19,SUBCLINICAL ATLAS,116,
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