Dermatopathic lymphadenopathy

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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:

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. 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.
  3. Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 226. ISBN 978-0781775960.