Follicular Lymphoma with Hyaline-vascular Castleman-like Features Analysis of 6 Cases and Review of the Literature

Follicular lymphoma (FL) with features reminiscent of hyaline-vascular Castleman disease (CD) is an unusual morphologic variant that may create diagnostic difficulties. To our knowledge, only 5 cases of this variant have been reported. We describe the clinicopathologic features of 6 cases including 2 men and 4 women with a median age of 63years (range, 41–77). Morphologically, all lymph node biopsy specimens showed at least a focal area of conventional FL; 4 cases showed neoplastic follicles with hyalinized blood vessels penetrating into germinal centers (lollipop-like lesions); 4 cases had interfollicular areas with increased vascular stroma, 2 cases showed small neoplastic follicles with prominent, onion skin-like mantle zones, and 1 case showed two or more germinal centers within follicles (twinning).

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