Reactive follicular hyperplasia
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Reactive follicular hyperplasia is a benign lymph node change.
General
- Many causes - including: bacteria, viruses, chemicals, drugs, allergens.
- In only approximately 10% can definitive cause be identified.[1]
Microscopic
Features:[2]
- Enlarged follicles, follicle size variation - key feature with:
- Large germinal centers (pale on H&E).
- Mitoses common.
- Variable lymphocyte morphology.
- Tingible-body macrophage (large, pale cells with junk in the cytoplasm).
- Germinal centers (GCs) have a crisp/sharp edge.
- Normal dark/light variation of GCs; superficial aspect light, deeper aspect darker.
- Rim of small (inactive) lymphocytes.
- Large germinal centers (pale on H&E).
DDx:
- Hodgkin lymphoma - with rare Reed-Sternberg cells.
- Non-Hodgkin lymphoma.
- T-cell/histiocyte-rich large B cell lymphoma.
Image: Normal lymph node (umdnj.edu).
IHC
Screening panel:
Others:
- BCL2 -ve.
- Germinal centers negative.
Images
See also
References
- ↑ Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 174. ISBN 978-0781775960.
- ↑ Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 179. ISBN 978-0781775960.