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Flashcards in Lymph Nodes Deck (343)
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1

Reactive follicular hyperplasia in rheumatoid arthritis: Histology.

Following treatment with gold salts: Scattered non-birefringent crystals with foreign-body reaction.

2

Reactive follicular hyperplasia in Sjögren's syndrome: Histology.

There may be aggregates of monocytoid B cells.

3

Reactive follicular hyperplasia in autoimmune disease: Proliferation.

Ki-67 stains more than 90% of cells in reactive germinal centers and about 5% in interfollicular areas.

4

Reactive follicular hyperplasia in autoimmune disease: PCR.

May show clonality of B cells, but this finding alone is not diagnostic of malignancy.

5

Syphilitic lymphadenopathy: Site.

Inguinal lymph nodes.

6

Syphilitic lymphadenopathy: Histology (3).

Thickening of capsule.

Marked plasmacytic infiltration.

Vasculitis.

7

Syphilitic lymphadenopathy: Locations of spirochetes (3).

Endothelial cells.

Blood vessels.

Germinal centers.

8

Early EBV lymphadenitis: Histology.

Expanded paracortex with many immunoblasts.

9

Follicular lymphoma: Histology of capsule.

Thickened and may appear split due to follicular proliferation.

10

Mantle-cell lymphoma: Association autoimmune diseases (2).

Sjögren's syndrome.

Hashimoto's thyroiditis.

11

Main cellular components of the ___.

A. Cortex.
B. Paracortex.
C. Medulla.
D. Sinuses.

A. B cells.

B. T cells.

C. Plasma cells.

D. Histiocytes.

12

Cytomegalovirus lymphadenitis: Early histology (2).

Reactive follicular hyperplasia.

Hyperplasia of monocytoid B cells.

13

Immunohistochemistry: All B lymphocytes (3).

Positive: CD20, CD79a, PAX5.

14

Immunohistochemistry of B cells ___.

A. Within the germinal centers (2,1).
B. Outside the germinal centers (1,2).

A. Positive: CD10, Bcl-6; negative: Bcl-2.

B. The inverse pattern.

15

Immunohistochemistry:

A. Follicular dendritic cells.
B. Antigen-presenting interdigitating dendritic cells.

A. Positive: CD21, CD23.

B. Positive: S100.

16

Reactive follicular hyperplasia in autoimmune disease: General histology (3).

Florid reactive follicular hyperplasia.

Sinus histiocytosis.

Markedly increased plasma cells in paracortex and medulla.

16

Cytomegalovirus lymphadenitis: Later histology (2).

Paracortical hyperplasia with immunoblasts.

Hypervascularity.

17

Cytomegalovirus lymphadenitis: Histology in the immunocompromised.

There may be necrosis.

18

Cytomegalovirus lymphadenitis: Best place to look for viral cytopathic effect.

In the collections of monocytoid B cells.

19

Cytomegalovirus lymphadenitis: Immunophenotype.

Infected cells may express CD15 (and possibly cause confusion with Hodgkin's lymphoma).

20

Toxoplasma lymphadenitis: Histology (3).

Follicular hyperplasia.

Hyperplasia of monocytoid B cells.

Aggregates of epithelioid histiocytes in lymphoid follicles.

21

Toxoplasma lymphadenitis: Presentation.

Bilateral cervical lymphadenopathy, non-tender.

22

Toxoplasma lymphadenitis: Demonstration of organism (2).

Immunohistochemistry: Usually not helpful.

Serology: Better.

23

Toxoplasma lymphadenitis vs. leishmania lymphadenitis (2).

Leishmania lymphadenitis:

- Granulomas with or without necrosis.
- Amastigotes may be seen.

24

Toxoplasma: Reactivation of infection in AIDS patients.

Usually as encephalitis instead of lymphadenitis.

25

HIV-related lymphadenopathy: Presentation (2).

Mainly involves axillary, cervical, and occipital nodes.

Lymph nodes decrease somewhat in size after acute presentation.

26

HIV-related lymphadenopathy: Criteria of persistent generalized lymphadenopathy (3).

More than 3 months.

At least 2 noncontiguous nodal sites.

No other explanation.

27

HIV-related lymphadenopathy: Early histology of follicles (4).

Large, irregular germinal centers.

Many mitotic figures and tingible-body macrophages in the germinal centers.

Follicle lysis.

Attenuated mantle zones.

28

HIV-related lymphadenopathy: Other early histology (2).

Paracortex: Granulocytes, conspicuous vessels.

Sinuses: Histiocytosis, erythrophagocytosis.

29

HIV-related lymphadenopathy: Later histology (3).

Small, atrophic, hyalinized follicles.

Paracortex: More histiocytes and plasma cells; fewer lymphocytes.

More blood vessels.