Category Archives: Lymph Node

Acute Lymphadenitis

Acute Lymphadenitis

 

Acute infection of lymph node from draining an infected focus.

 

Acute lymphadenitis consists of:

Neutrophils

Necrosis

Abscess formation

 

Acute lymphadenitis is seen in:

Bacterial infections

 

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Reactive lymphadenopathy

Reactive lymphadenopathy

Reactive lymphadenopathy has five different architectural patterns. Most changes are a mixture of the five patterns.

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Hyperplasia

Follicular Hyperplasia

Follicular hyperplasia consists of:

Increased number of B cell germinal centers

Increased size of B cell germinal centers

 

Follicular hyperplasia is seen in:

Adult-onset still disease

Systemic lupus erythematosus

Kikuchi-Fujimoto disease

Kimura disease

Cat-scratch disease

Toxoplasmosis

Castleman disease

Syphilis (also with a thick capsule from fibrosis and many plasma cells in the medullary region)

HIV (lymphadenitis)

Rheumatoid arthritis (rheumatoid lymphadenopathy)

 

Diffuse Hyperplasia

 Diffuse hyperplasia consists of:

Hyperplasia of the paracortical region, with expansion of T-cell areas.

 

Diffuse hyperplasia is seen in:

Whipple disease

Viral adenitis (EBV, CMV, Herpes, Vaccinia)

Phenytoin lymphadenopathy (drug)

Post-transplant lymphoproliferative disorder

Rosai-Dorfman disease

 

Sinus Hyperplasia

 

Sinus hyperplasia is:

Increased cellularity within medullary sinuses

 

Sinus hyperplasia is seen in:

Chronic inflammation

Rosai-Dorfman disease (with massive lymphadenopathy and CD68 and S-100 positive histiocytes)

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Lymph Node Architecture

Lymph Node Architecture

Lymph nodes consist basically of four compartments: Primary and secondary follicles found near the capsule, paracortex which surrounds the follicles, medullary region and sinuses.

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Lymph Nodes in Surgery

Lymph Nodes in Surgery

Lymph nodes are the most accessible of the lymphoid tissues and lymphoreticular system as they are often found close to the skin and are therefore easily removed for pathological examination.

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Lymphoreticular system

Lymphoreticular system

Lymph nodes are part of the lymphoreticular system, which consists of lymphoid tissue collections. Tissues included in the lymphoreticular system include the adenoids, tonsils, thymus, spleen and Peyer patches of the gut, as well as lymph nodes. Lymph nodes are the most widely distributed of the lymphoid tissues.

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Cat Scratch Disease

Cat Scratch Disease

Cat scratch disease is a regional lymphadenopathy of the axillary, cervical and inguinal regions. It usually presents about 3 weeks after a primary exposure. The causative organisms is Bartonella henselae. This organism can be detected through serologic tests or molecular genetics.

Microscopically, affected lymph nodes demonstrate interfollicular microabscesses with small epithelioid histiocytes surrounding necrotic foci contain central polymorphonuclear leukocytes. Often capsulitis if prominent.

Differential Diagnosis

Yersinia infections

Lymphogranuloma venereum

Tularemia

Mycobacterium, avian-intracellulare infection

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Castleman’s Disease

Castleman’s Disease

Castleman's Disease

Castleman's Disease in a Lymph Node

Castleman's Disease Hyaline Variant

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