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Hyaline-Vascular Castleman Disease

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Microscopic Features of Hyaline-Vascular Castleman Disease (HVCD) (continued): This photomicrograph shows a small germinal center that is lymphocyte-depleted and surrounded by an expanded mantle zone consisting of concentric layers of lymphocytes. The hyalinized cores of the germinal centers are composed mostly of CD21+ and CD35+ follicular dendritic cells (FDC), endothelial cells of proliferating vessels and scant residual follicle-center B-cells.

The FDC can become dysplastic and show molecular evidence of clonal proliferation. They may be precursors to the FDC tumors and high-grade spindle cell sarcomas that sometimes occur in patients with Castleman disease.

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