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Difference between revisions of "Lymph node pathology"
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This article deals with '''lymph node pathology'''. An introduction to the lymph node is in the ''[[lymph nodes]]'' article. | This article deals with non-haematologic malignant and non-malignant '''lymph node pathology'''. An introduction to the lymph node is in the ''[[lymph nodes]]'' article. | ||
Haematologic Malignancy in lymph nodes is dealt with in other articles - see ''[[haematolopathology]]''. | |||
==Overview in a table== | |||
{| class="wikitable" | |||
! Entity | |||
! Key feature | |||
! Other findings | |||
! IHC | |||
! DDx | |||
! Image | |||
|- | |||
| Non-specific reactive follicular hyperplasia (NSRFH) | |||
| large spaced cortical follicles | |||
| tingible body macrophages, normal dark/light GC pattern | |||
| BCL-2 -ve | |||
| infection (Toxoplasmosis, HIV/AIDS), [[Hodgkin's lymphoma]] | |||
| image ? | |||
|- | |||
| Toxoplasmosis | |||
| large follicles; epithelioid cells perifollicular & intrafollicular | |||
| reactive GCs, monocytoid cell clusters, epithelioid cells | |||
| IHC ? | |||
| NSRFH, HIV/AIDS, Hodgkin's lymphoma | |||
| image ? | |||
|- | |||
| Kikuchi disease | |||
| No PMNs | |||
| histiocytes, necrosis | |||
| IHC neg. for malignancy | |||
| SLE (has (blue) hematoxylin bodies in necrotic areas) | |||
| image ? | |||
|- | |||
| Cat-scratch disease | |||
| PMNs in necrotic area | |||
| "stellate" (or serpentine) shaped microabscesses, granulomas | |||
| B. henselae, Dieterle stain | |||
| HIV/AIDS, NSRFH | |||
| image ? | |||
|- | |||
| Dermatopathic lymphadenopathy | |||
| melanin-laden histiocytes | |||
| histiocytosis | |||
| S100+ve (interdigitating dendritic cells), CD1a+ve (Langerhans cells) | |||
| DDx ? | |||
| image ? | |||
|- | |||
| entity | |||
| key feature | |||
| other features | |||
| IHC | |||
| DDx | |||
| image | |||
|} | |||
===Follicular lymphoma vs. reactive follicular hyperplasia=== | |||
Factors to consider:<ref>DB. 4 August 2010.</ref> | |||
{| class="wikitable" | |||
! | |||
! Reactive follicular <br>hyperplasia | |||
! Follicular lymphoma | |||
|- | |||
| Follicle location | |||
| cortex | |||
| cortex and medulla | |||
|- | |||
| Germinal center edge | |||
| sharp/well-demarcated | |||
| poorly demarcated | |||
|- | |||
| Germinal center density | |||
| well spaced | |||
| crowded | |||
|- | |||
| Tingible body <br>macrophages | |||
| common | |||
| uncommon | |||
|- | |||
| Germinal center<br>light/dark pattern | |||
| normal | |||
| abnormal | |||
|} | |||
==Progressive transformation of germinal centers== | ==Progressive transformation of germinal centers== | ||
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Image: [http://pleiad.umdnj.edu/hemepath/normal_node/normal_node.html Normal lymph node (umdnj.edu)]. | Image: [http://pleiad.umdnj.edu/hemepath/normal_node/normal_node.html Normal lymph node (umdnj.edu)]. | ||
==Diffuse paracortical hyperplasia== | ==Diffuse paracortical hyperplasia== | ||