Difference between revisions of "Sinus histiocytosis"

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'''Sinus histiocytosis'''
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Sinus histiocytosis -- intermed mag.jpg
| Width      =
| Caption    = Sinus histiocytosis. [[H&E stain]].
| Micro      = sinuses distended with histiocytes without atypia
| Subtypes  =
| LMDDx      = [[Rosai-Dorfman disease]], [[dermatopathic lymphadenopathy]], [[lymph node metastasis]]
| Stains    =
| IHC        = CD68 +ve, S-100 -ve, pankeratin -ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[lymph node]] - see ''[[lymph node pathology]]''
| Assdx      =
| Syndromes  =
| Clinicalhx = variable
| Signs      =
| Symptoms  =
| Prevalence = common
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    = other causes of lymphadenopathy esp. [[lymphoma]], [[lymph node metastasis]]
}}
'''Sinus histiocytosis''', abbreviated '''SH''', is a common finding in [[lymph nodes]]. 
 
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.<ref name=pmid18504582>{{Cite journal  | last1 = Hartmann | first1 = S. | last2 = Kriener | first2 = S. | last3 = Hansmann | first3 = ML. | title = [Diagnostic spectrum of reactive lymph node changes]. | journal = Pathologe | volume = 29 | issue = 4 | pages = 253-63 | month = Jul | year = 2008 | doi = 10.1007/s00292-008-1003-5 | PMID = 18504582 }}</ref>
*Reported in association with hip replacements.<ref name=pmid8279630>{{Cite journal  | last1 = Albores-Saavedra | first1 = J. | last2 = Vuitch | first2 = F. | last3 = Delgado | first3 = R. | last4 = Wiley | first4 = E. | last5 = Hagler | first5 = H. | title = Sinus histiocytosis of pelvic lymph nodes after hip replacement. A histiocytic proliferation induced by cobalt-chromium and titanium. | journal = Am J Surg Pathol | volume = 18 | issue = 1 | pages = 83-90 | month = Jan | year = 1994 | doi =  | PMID = 8279630 }}
</ref>
 
==Gross==
*+/-Enlargement of lymph node.<ref name=pmid2051659>{{Cite journal  | last1 = Saito | first1 = T. | last2 = Kuwahara | first2 = A. | last3 = Kaketani | first3 = K. | last4 = Hirao | first4 = E. | last5 = Miyahara | first5 = M. | last6 = Shimoda | first6 = K. | last7 = Kobayashi | first7 = M. | title = Preoperative assessment of cervical lymph node involvement in esophageal cancer. | journal = Jpn J Surg | volume = 21 | issue = 2 | pages = 145-53 | month = Mar | year = 1991 | doi =  | PMID = 2051659 }}</ref>
 
==Microscopic==
Features:<ref name=Ref_ILNP179>{{Ref_ILNP|179}}</ref>
*Sinuses distended with histiocytes - '''key feature'''.
**Histocytes: abundant foamy cytoplasm, +/-[[anthracotic pigment]] and/or [[yellow bodies]].
*[[Plasma cell]]s increased.
 
DDx:
*[[Rosai-Dorfman disease]] - histiocytes have a large round nucleus (~2-3x the size of a lymphocyte) with a prominent nucleolus.
*[[Dermatopathic lymphadenopathy]] - histiocytes have (melanin) pigment.
*[[Lymph node metastasis]] - usually not difficult to exclude, esp. if one compares the germinal center macrophages and the primary tumour.
 
===Images===
<gallery>
Image: Sinus histiocytosis -- intermed mag.jpg | SH - intermed. mag.
Image: Sinus histiocytosis -- high mag.jpg | SH - high mag.
Image: Sinus histiocytosis - deep -- high mag.jpg | SH - high mag.
</gallery>
 
==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==
==See also==
*[[Lymph node pathology]].
*[[Lymph node pathology]].
*[[Dermatopathic lymphadenopathy]]
*[[Dermatopathic lymphadenopathy]].
 
==References==
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Lymph node pathology]]
[[Category:Lymph node pathology]]

Latest revision as of 03:50, 22 October 2014

Sinus histiocytosis
Diagnosis in short

Sinus histiocytosis. H&E stain.
LM sinuses distended with histiocytes without atypia
LM DDx Rosai-Dorfman disease, dermatopathic lymphadenopathy, lymph node metastasis
IHC CD68 +ve, S-100 -ve, pankeratin -ve
Site lymph node - see lymph node pathology
Clinical history variable
Prevalence common
Prognosis benign
Clin. DDx other causes of lymphadenopathy esp. lymphoma, lymph node metastasis

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

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]

DDx:

Images

  • SH - intermed. mag.

  • SH - high mag.

  • SH - high mag.

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.
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