Sinus histiocytosis: Difference between revisions
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Sinus histiocytosis -- intermed mag.jpg | |||
| Width = | |||
| Caption = Sinus histiocytosis. [[H&E stain]]. | |||
| Micro = sinuses distended with histiocytes without atypia | |||
| Subtypes = | |||
| LMDDx = [[Rosai-Dorfman disease]], [[dermatopathic lymphadenopathy]], [[lymph node metastasis]] | |||
| Stains = | |||
| IHC = CD68 +ve, S-100 -ve, pankeratin -ve | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[lymph node]] - see ''[[lymph node pathology]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = variable | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = common | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = other causes of lymphadenopathy esp. [[lymphoma]], [[lymph node metastasis]] | |||
}} | |||
'''Sinus histiocytosis''', abbreviated '''SH''', is a common finding in [[lymph nodes]]. | |||
It should '''not''' be confused with [[Rosai-Dorfman disease]] (also known as ''sinus histiocytosis and massive lymphadenopathy''). | |||
==General== | |||
*Benign. | |||
*Non-specific finding. | |||
*Frequently associated with infections and neoplasia.<ref name=pmid18504582>{{Cite journal | last1 = Hartmann | first1 = S. | last2 = Kriener | first2 = S. | last3 = Hansmann | first3 = ML. | title = [Diagnostic spectrum of reactive lymph node changes]. | journal = Pathologe | volume = 29 | issue = 4 | pages = 253-63 | month = Jul | year = 2008 | doi = 10.1007/s00292-008-1003-5 | PMID = 18504582 }}</ref> | |||
*Reported in association with hip replacements.<ref name=pmid8279630>{{Cite journal | last1 = Albores-Saavedra | first1 = J. | last2 = Vuitch | first2 = F. | last3 = Delgado | first3 = R. | last4 = Wiley | first4 = E. | last5 = Hagler | first5 = H. | title = Sinus histiocytosis of pelvic lymph nodes after hip replacement. A histiocytic proliferation induced by cobalt-chromium and titanium. | journal = Am J Surg Pathol | volume = 18 | issue = 1 | pages = 83-90 | month = Jan | year = 1994 | doi = | PMID = 8279630 }} | |||
</ref> | |||
==Gross== | |||
*+/-Enlargement of lymph node.<ref name=pmid2051659>{{Cite journal | last1 = Saito | first1 = T. | last2 = Kuwahara | first2 = A. | last3 = Kaketani | first3 = K. | last4 = Hirao | first4 = E. | last5 = Miyahara | first5 = M. | last6 = Shimoda | first6 = K. | last7 = Kobayashi | first7 = M. | title = Preoperative assessment of cervical lymph node involvement in esophageal cancer. | journal = Jpn J Surg | volume = 21 | issue = 2 | pages = 145-53 | month = Mar | year = 1991 | doi = | PMID = 2051659 }}</ref> | |||
==Microscopic== | |||
Features:<ref name=Ref_ILNP179>{{Ref_ILNP|179}}</ref> | |||
*Sinuses distended with histiocytes - '''key feature'''. | |||
**Histocytes: abundant foamy cytoplasm, +/-[[anthracotic pigment]] and/or [[yellow bodies]]. | |||
*[[Plasma cell]]s increased. | |||
DDx: | |||
*[[Rosai-Dorfman disease]] - histiocytes have a large round nucleus (~2-3x the size of a lymphocyte) with a prominent nucleolus. | |||
*[[Dermatopathic lymphadenopathy]] - histiocytes have (melanin) pigment. | |||
*[[Lymph node metastasis]] - usually not difficult to exclude, esp. if one compares the germinal center macrophages and the primary tumour. | |||
===Images=== | |||
<gallery> | |||
Image: Sinus histiocytosis -- intermed mag.jpg | SH - intermed. mag. | |||
Image: Sinus histiocytosis -- high mag.jpg | SH - high mag. | |||
Image: Sinus histiocytosis - deep -- high mag.jpg | SH - high mag. | |||
</gallery> | |||
==IHC== | |||
*CD68 +ve. | |||
*S-100 -ve. | |||
*Pankeratin -ve. | |||
**Used to excluded metastatic carcinoma. | |||
==Sign out== | |||
*The finding is often ignored; may be signed out as ''morphologically benign lymph nodes''. | |||
==See also== | |||
*[[Lymph node pathology]]. | |||
*[[Dermatopathic lymphadenopathy]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Lymph node pathology]] | |||