Flashcards in Lymph Nodes Deck (343)
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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.
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Syphilitic lymphadenopathy: Site.
Inguinal lymph nodes.
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Syphilitic lymphadenopathy: Histology (3).
Thickening of capsule.
Marked plasmacytic infiltration.
Vasculitis.
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Syphilitic lymphadenopathy: Locations of spirochetes (3).
Endothelial cells.
Blood vessels.
Germinal centers.
8
Early EBV lymphadenitis: Histology.
Expanded paracortex with many immunoblasts.
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Follicular lymphoma: Histology of capsule.
Thickened and may appear split due to follicular proliferation.
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Mantle-cell lymphoma: Association autoimmune diseases (2).
Sjögren's syndrome.
Hashimoto's thyroiditis.
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Main cellular components of the ___.
A. Cortex.
B. Paracortex.
C. Medulla.
D. Sinuses.
A. B cells.
B. T cells.
C. Plasma cells.
D. Histiocytes.
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Cytomegalovirus lymphadenitis: Early histology (2).
Reactive follicular hyperplasia.
Hyperplasia of monocytoid B cells.
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Immunohistochemistry: All B lymphocytes (3).
Positive: CD20, CD79a, PAX5.
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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.
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Immunohistochemistry:
A. Follicular dendritic cells.
B. Antigen-presenting interdigitating dendritic cells.
A. Positive: CD21, CD23.
B. Positive: S100.
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Reactive follicular hyperplasia in autoimmune disease: General histology (3).
Florid reactive follicular hyperplasia.
Sinus histiocytosis.
Markedly increased plasma cells in paracortex and medulla.
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Cytomegalovirus lymphadenitis: Later histology (2).
Paracortical hyperplasia with immunoblasts.
Hypervascularity.
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Cytomegalovirus lymphadenitis: Histology in the immunocompromised.
There may be necrosis.
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Cytomegalovirus lymphadenitis: Best place to look for viral cytopathic effect.
In the collections of monocytoid B cells.
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Cytomegalovirus lymphadenitis: Immunophenotype.
Infected cells may express CD15 (and possibly cause confusion with Hodgkin's lymphoma).
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Toxoplasma lymphadenitis: Histology (3).
Follicular hyperplasia.
Hyperplasia of monocytoid B cells.
Aggregates of epithelioid histiocytes in lymphoid follicles.
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Toxoplasma lymphadenitis: Presentation.
Bilateral cervical lymphadenopathy, non-tender.
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Toxoplasma lymphadenitis: Demonstration of organism (2).
Immunohistochemistry: Usually not helpful.
Serology: Better.
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Toxoplasma lymphadenitis vs. leishmania lymphadenitis (2).
Leishmania lymphadenitis:
- Granulomas with or without necrosis.
- Amastigotes may be seen.
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Toxoplasma: Reactivation of infection in AIDS patients.
Usually as encephalitis instead of lymphadenitis.
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HIV-related lymphadenopathy: Presentation (2).
Mainly involves axillary, cervical, and occipital nodes.
Lymph nodes decrease somewhat in size after acute presentation.
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HIV-related lymphadenopathy: Criteria of persistent generalized lymphadenopathy (3).
More than 3 months.
At least 2 noncontiguous nodal sites.
No other explanation.
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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.
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HIV-related lymphadenopathy: Other early histology (2).
Paracortex: Granulocytes, conspicuous vessels.
Sinuses: Histiocytosis, erythrophagocytosis.
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