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| *Neoplastic - lymphoma, carcinoma. | | *Neoplastic - lymphoma, carcinoma. |
| *Endocrine - [[hyperthyroidism]]. | | *Endocrine - [[hyperthyroidism]]. |
| *Trauma. | | *Trauma. |
| *Autoimmune - [[SLE]], [[RA]], [[dermatomyositis]]. | | *Autoimmune - [[SLE]], [[RA]], [[dermatomyositis]]. |
| *Inflammatory - drugs (phenytoin). | | *Inflammatory - drugs (phenytoin). |
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| ==Reactive follicular hyperplasia== | | ==Reactive follicular hyperplasia== |
| ===General===
| | {{Main|Reactive follicular hyperplasia}} |
| *Many causes - including: bacteria, viruses, chemicals, drugs, allergens.
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| **In only approximately 10% can definitive cause be identified.<ref name=Ref_ILNP174>{{Ref_ILNP|174}}</ref>
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| ===Microscopic===
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| Features:<ref name=Ref_ILNP179>{{Ref_ILNP|179}}</ref>
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| *Enlarged follicles, follicle size variation - '''key feature''' with:
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| **Large germinal centers (pale on H&E).
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| ***Mitoses common.
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| ***Variable lymphocyte morphology.
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| ***Tingible-body macrophage (large, pale cells with junk in the cytoplasm).
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| ***Germinal centers (GCs) have a crisp/sharp edge.
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| ***Normal dark/light variation of GCs; superficial aspect light, deeper aspect darker.
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| **Rim of small (inactive) lymphocytes.
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| DDx:
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| *[[Hodgkin lymphoma]] - with rare Reed-Sternberg cells.
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| *Non-Hodgkin [[lymphoma]].
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| **T-cell/histiocyte-rich large B cell lymphoma.
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| Image: [http://pleiad.umdnj.edu/hemepath/normal_node/normal_node.html Normal lymph node (umdnj.edu)].
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| ===IHC===
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| Screening panel:
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| *CD3.
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| *CD5.
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| *CD10.
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| *CD20.
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| *CD30.
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| *CD15.
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| Others:
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| *BCL2 -ve.
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| ==Diffuse paracortical hyperplasia== | | ==Diffuse paracortical hyperplasia== |