Figure 2

The pathological exam suggests Castleman’s disease. The gross examination of the inguenal lymph node biopsy specimen shows a fairly well-encapsulated, soft tan lesion with a largest dimension of 1.2 cm. Microscopy reveals areas of hyaline-vascular Castleman’s disease-like pattern. The majority of the lymphoid follicles had atrophic or regressive germinal centers, and some of them are penetrated by capillaries. There was concentric layering of lymphocytes in an onion-skin appearance and one or more penetrating blood vessels. The interfollicular stroma was also prominent with numerous hyperplastic vessels of the post-capillary venule type and plump endothelial lining. (A) concentric layering of lymphocytes in an onion-skin appearance; (B) a “lollipop” appearance; (C) two atrophic germinal centers within a single mantle zone.