Sinus histiocytosis

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Sinus histiocytosis, abbreviated SH, is a common finding in lymph nodes.

Sinus histiocytosis
Diagnosis in short

Sinus histiocytosis. H&E stain.
LM DDx Rosai-Dorfman disease, dermatopathic lymphadenopathy, lymph node metastasis
Site lymph node - see lymph node pathology

Clinical history varaible
Prevalence common
Prognosis benign
Clin. DDx other causes of lymphadenopathy esp. lymphoma, lymph node metastasis

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.[1]
  • Reported in association with hip replacements.[2]

Gross

  • +/-Enlargement of lymph node.[3]

Microscopic

Features:[4]

  • Sinuses distended with histiocytes - key feature.
    • Histocytes: abundant foamy cytoplasm, +/-anthrocotic pigment.
  • Plasma cells increased.

DDx:

Images

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

References

  1. Hartmann, S.; Kriener, S.; Hansmann, ML. (Jul 2008). "[Diagnostic spectrum of reactive lymph node changes].". Pathologe 29 (4): 253-63. doi:10.1007/s00292-008-1003-5. PMID 18504582.
  2. Albores-Saavedra, J.; Vuitch, F.; Delgado, R.; Wiley, E.; Hagler, H. (Jan 1994). "Sinus histiocytosis of pelvic lymph nodes after hip replacement. A histiocytic proliferation induced by cobalt-chromium and titanium.". Am J Surg Pathol 18 (1): 83-90. PMID 8279630.
  3. Saito, T.; Kuwahara, A.; Kaketani, K.; Hirao, E.; Miyahara, M.; Shimoda, K.; Kobayashi, M. (Mar 1991). "Preoperative assessment of cervical lymph node involvement in esophageal cancer.". Jpn J Surg 21 (2): 145-53. PMID 2051659.
  4. Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 179. ISBN 978-0781775960.