Difference between revisions of "Lymph node pathology"
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==Castleman disease== | ==Castleman disease== | ||
===General=== | ===General=== | ||
*Benign. ( | *[[AKA]] ''angiofollicular lymph node hyperplasia'', ''giant lymph node hyperplasia''.<ref>URL: [http://www.mayoclinic.com/health/castleman-disease/DS01000 http://www.mayoclinic.com/health/castleman-disease/DS01000]. Accessed on: 17 June 2010.</ref> | ||
*Benign. | |||
*Abbreviated '''CD'''. | |||
===Classification=== | |||
CD is grouped by location/involvment: | |||
*Hyaline vascular variant. | |||
**Usually unicentric. | |||
**Typically mediastinal or axial. | |||
*Plasma cell variant. | |||
**Usually multicentric. | |||
**Abundant plasma cells. | |||
**Associated with HHV-8 infection (the same virus implicated in ''Kaposi's sarcoma''). | |||
Discussed here: <ref name=pmid19546611>PMID 19546611</ref> | |||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref>URL: [http://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_9_number_2_11/article/a_rare_case_of_castleman_s_disease_presenting_as_cervical_neck_mass.html http://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_9_number_2_11/article/a_rare_case_of_castleman_s_disease_presenting_as_cervical_neck_mass.html]. Accessed on: 15 June 2010.</ref> | Features:<ref>URL: [http://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_9_number_2_11/article/a_rare_case_of_castleman_s_disease_presenting_as_cervical_neck_mass.html http://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_9_number_2_11/article/a_rare_case_of_castleman_s_disease_presenting_as_cervical_neck_mass.html]. Accessed on: 15 June 2010.</ref> | ||
*Pale concentric mantle zone lymphocytes. | *Pale concentric (expanded) mantle zone lymphocytes. | ||
**"Regressed follicle". (???) | |||
*"Lollipops" - germinal centers fed by prominent vessels; lollipop-like appearance. | *"Lollipops" - germinal centers fed by prominent vessels; lollipop-like appearance. | ||
*Two germinal centers in one follicle. | *Two germinal centers in one follicle. |
Revision as of 03:26, 18 June 2010
This article deals with lymph node pathology. An introduction to the lymph node is in the lymph nodes article.
Kikuchi disease
General
- AKA histiocytic necrotising lymphadenitis (HNL).[1]
- Rare disease that may mimic cancer, esp. lymphoma.
- May cause fever & systemic symptoms.[2]
Epidemiology:[2]
- Usually <40 years old.
- Asian.
- Female:Male = 3:1.[3]
Treatment:
- Usually self-limited.[2]
- Oral corticosteroids.
DDx:
- Non-Hodgkin lymphoma.
- Systemic lupus erythematosus.
Micrograph
Features (the three main features - just as the name suggests):[4]
- Histiocytes.
- May be crescentic.
- Necrosis (due to apoptosis) - paracortical areas.[2]
- Necrosis without neutrophils - key feature.
- Lymphocytes (CD8 +ve).
- Plasmacytoid dendritic cells.
Notes:
- Dendritic cell - vaguely resembles a macrophage:[5]
- Long membrane projections - key feature.
- Abundant blue-grey cytoplasm, +/- ground-glass appearance.
- Nucleus: small, ovoid, usu. single nucleolous.
Images:
IHC
- CD68 +ve.
- CD8 +ve.
- CD4, CD20, CD3, and CD30 - mixed.
- Done to excluded lymphoma; should show a mixed population of lymphocytes.
Castleman disease
General
- AKA angiofollicular lymph node hyperplasia, giant lymph node hyperplasia.[6]
- Benign.
- Abbreviated CD.
Classification
CD is grouped by location/involvment:
- Hyaline vascular variant.
- Usually unicentric.
- Typically mediastinal or axial.
- Plasma cell variant.
- Usually multicentric.
- Abundant plasma cells.
- Associated with HHV-8 infection (the same virus implicated in Kaposi's sarcoma).
Discussed here: [7]
Microscopic
Features:[8]
- Pale concentric (expanded) mantle zone lymphocytes.
- "Regressed follicle". (???)
- "Lollipops" - germinal centers fed by prominent vessels; lollipop-like appearance.
- Two germinal centers in one follicle.
Cat-scratch disease
General
- AKA Cat-scratch fever,
- Infection caused by spirochete Bartonella henselae.[9]
- Treatment: antibiotics.
Micrograph
Features:
- Palisading granulomas with neutrophils in the center.
Stains:
- Warthin-Starry stain.
Image(s):
See also
References
- ↑ Kaushik V, Malik TH, Bishop PW, Jones PH (June 2004). "Histiocytic necrotising lymphadenitis (Kikuchi's disease): a rare cause of cervical lymphadenopathy". Surgeon 2 (3): 179–82. PMID 15570824.
- ↑ 2.0 2.1 2.2 2.3 Hutchinson CB, Wang E (February 2010). "Kikuchi-Fujimoto disease". Arch. Pathol. Lab. Med. 134 (2): 289–93. PMID 20121621.
- ↑ URL: http://emedicine.medscape.com/article/210752-overview. Accessed on: 3 June 2010.
- ↑ URL: http://www.ispub.com/journal/the_internet_journal_of_head_and_neck_surgery/volume_1_number_1_30/article_printable/kikuchi_s_lymphadenitis_in_a_young_male.html. Accessed on: 1 June 2010.
- ↑ URL: http://www.healthsystem.virginia.edu/internet/hematology/hessedd/benignhematologicdisorders/normal-hematopoietic-cells/dendritic-cell.cfm?drid=214. Accessed on: 3 June 2010.
- ↑ URL: http://www.mayoclinic.com/health/castleman-disease/DS01000. Accessed on: 17 June 2010.
- ↑ PMID 19546611
- ↑ URL: http://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_9_number_2_11/article/a_rare_case_of_castleman_s_disease_presenting_as_cervical_neck_mass.html. Accessed on: 15 June 2010.
- ↑ Jerris, RC.; Regnery, RL. (1996). "Will the real agent of cat-scratch disease please stand up?". Annu Rev Microbiol 50: 707-25. doi:10.1146/annurev.micro.50.1.707. PMID 8905096.