Difference between revisions of "Dermatopathic lymphadenopathy"
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==General== | ==General== | ||
*Lymphadenopathy associated with a skin lesion - '''key feature'''. | *Lymphadenopathy associated with a skin lesion - '''key feature'''. | ||
*May be | *Benign in itself.<ref name=pmid17176922>{{Cite journal | last1 = Westhoff | first1 = TH. | last2 = Loddenkemper | first2 = C. | last3 = Hörl | first3 = MP. | last4 = Schmidt | first4 = S. | last5 = Anagnostopoulos | first5 = I. | last6 = Hummel | first6 = M. | last7 = Zidek | first7 = W. | last8 = van der Giet | first8 = M. | title = Dermatopathic lymphadenopathy: a differential diagnosis of enlarged lymph nodes in uremic pruritus. | journal = Clin Nephrol | volume = 66 | issue = 6 | pages = 472-5 | month = Dec | year = 2006 | doi = | PMID = 17176922 }}</ref> | ||
**May be associated with a malignancy (e.g. T-cell lymphoma).<ref name=pmid15173917>{{Cite journal | last1 = Kojima | first1 = M. | last2 = Nakamura | first2 = S. | last3 = Itoh | first3 = H. | last4 = Yamane | first4 = Y. | last5 = Shimizu | first5 = K. | last6 = Murayama | first6 = K. | last7 = Ohno | first7 = Y. | last8 = Tanaka | first8 = H. | last9 = Sugihara | first9 = S. | title = Clinical implication of dermatopathic lymphadenopathy among Japanese: a report of 19 cases. | journal = Int J Surg Pathol | volume = 12 | issue = 2 | pages = 127-32 | month = Apr | year = 2004 | doi = | PMID = 15173917 }}</ref> | |||
==Microscopic== | ==Microscopic== | ||
Revision as of 03:33, 10 December 2013
Dermatopathic lymphadenopathy, abbreviated DL, is a rare pathology of the lymph nodes.
General
- Lymphadenopathy associated with a skin lesion - key feature.
- Benign in itself.[1]
- May be associated with a malignancy (e.g. T-cell lymphoma).[2]
Microscopic
Features:[3]
- Abundant histiocytes & special histiocytes - in loose irregular clusters - located in the sinuses, i.e. sinus histiocytosis - key feature:
- Do not form granuloma; may be similar to toxoplasma.
- Plasma cells (medulla).
- Eosinophils.
Histiocytes & special histiocytes:
- Histiocytes:
- +/-Melanin pigment key feature (if present).
- Lipid-laden macrophages.
- Interdigitating dendritic cells:
- Need IHC to identify definitively.
- Langerhans cells:
- Classically have a kidney bean nuclei.
- Need IHC to identify definitively.
DDx:
- Metastatic malignant melanoma - (melanin) pigmented cells have nuclear atypia, not histiocytes.
- Sinus histiocytosis - no cells with melanin.
Images
DL - very low mag. (WC)
DL - low mag. (WC)
DL - intermed. mag. (WC)
DL - high mag. (WC)
DL - very high mag. (WC)
IHC
- Interdigitating dendritic cells: S100 +ve, CD1a -ve.
- Langerhans cells: S100 +ve, CD1a +ve.
See also
References
- ↑ Westhoff, TH.; Loddenkemper, C.; Hörl, MP.; Schmidt, S.; Anagnostopoulos, I.; Hummel, M.; Zidek, W.; van der Giet, M. (Dec 2006). "Dermatopathic lymphadenopathy: a differential diagnosis of enlarged lymph nodes in uremic pruritus.". Clin Nephrol 66 (6): 472-5. PMID 17176922.
- ↑ Kojima, M.; Nakamura, S.; Itoh, H.; Yamane, Y.; Shimizu, K.; Murayama, K.; Ohno, Y.; Tanaka, H. et al. (Apr 2004). "Clinical implication of dermatopathic lymphadenopathy among Japanese: a report of 19 cases.". Int J Surg Pathol 12 (2): 127-32. PMID 15173917.
- ↑ Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 226. ISBN 978-0781775960.