Difference between revisions of "Dermatopathic lymphadenopathy"

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*Lymphadenopathy associated with a skin lesion - '''key feature'''.
*Lymphadenopathy associated with a skin lesion - '''key feature'''.
*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>  
*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>
**May be associated with a malignancy - esp. T-cell lymphoma.<ref name=pmid5341844>{{Cite journal  | last1 = Cooper | first1 = RA. | last2 = Dawson | first2 = PJ. | last3 = Rambo | first3 = ON. | title = Dermatopathic lymphadenopathy a clinicopathologic analysis of lymph node biopsy over a fifteen-year period. | journal = Calif Med | volume = 106 | issue = 3 | pages = 170-5 | month = Mar | year = 1967 | doi =  | PMID = 5341844 }}
</ref><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 03:36, 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 - esp. T-cell lymphoma.[2][3]

Microscopic

Features:[4]

  • 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:

Images

IHC

  • Interdigitating dendritic cells: S100 +ve, CD1a -ve.
  • Langerhans cells: S100 +ve, CD1a +ve.

See also

References

  1. 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.
  2. Cooper, RA.; Dawson, PJ.; Rambo, ON. (Mar 1967). "Dermatopathic lymphadenopathy a clinicopathologic analysis of lymph node biopsy over a fifteen-year period.". Calif Med 106 (3): 170-5. PMID 5341844.
  3. 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.
  4. Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 226. ISBN 978-0781775960.