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:
- Metastatic malignant melanoma - (melanin) pigmented cells have nuclear atypia, not histiocytes.
- Sinus histiocytosis - no cells with melanin.
Images
DL - very low mag. (WC)
DL - low mag. (WC)
DL - intermed. mag. (WC)
DL - high mag. (WC)
DL - very high mag. (WC)
IHC
- Interdigitating dendritic cells: S100 +ve, CD1a -ve.
- Langerhans cells: S100 +ve, CD1a +ve.
See also
References
- ↑ 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.
- ↑ 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.
- ↑ Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 226. ISBN 978-0781775960.