Flashcards in Lymph Nodes Deck (343)
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60
Infectious mononucleosis: Immunohistochemistry (2,1,2).
Positive: CD20, Mum-1.
Variable: CD30.
Negative: CD10, CD15.
61
Infectious mononucleosis: Molecular study.
In-situ hybridization for EBV (EBER).
62
Infectious mononucleosis vs. CMV lymphadenitis (2).
CMV lymphadenitis:
- IHC demonstrates presence of CMV.
- EBER negative.
63
Herpes simplex lymphadenitis: Presentation (2).
Localized or generalized.
Usually painful.
64
Herpes simplex lymphadenitis: Histology (3).
Paracortical hyperplasia with many immunoblasts.
Multifocal necrosis with neutrophils.
Typical viral cytopathic effect.
65
Herpes simplex lymphadenitis vs. other necrotizing lymphadenitides.
HSV lymphadenitis: No granulomas associated with the necrosis.
66
Dermatopathic lymphadenitis: Histology (2).
Paracortical expansion, diffuse or nodular.
Many interdigitating dendritic cells, Langerhans' cells, and histiocytes that contain melanin.
67
Dermatopathic lymphadenitis vs. mycosis fungoides (2).
Mycosis fungoides:
- Atypical lymphocytes present singly, in clusters, or in large aggregates.
- PCR may be needed to exclude rearrangement of the T-cell receptor.
68
Dermatopathic lymphadenitis vs. Langerhans' cell histiocytosis.
LCH: Langerhans' cells fill the sinuses and are accompanied by eosinophils, neutrophils, plasma cells, and histiocytes.
69
Drug-related lymphadenopathy:
A. Timing.
B. Involved nodes.
A. Within 2 to 8 weeks after exposure to the drug.
B. Cervical lymph nodes or all nodes.
70
Drug-related lymphadenopathy: Causes (2).
Antiepileptics.
Allopurinol.
71
Drug-related lymphadenopathy: Histology.
Paracortical expansion with immunoblasts and eosinophilia.
Immunoblasts may form large aggregates.
72
Drug-related lymphadenopathy: Most powerful tool for diagnosis.
Clinical history of exposure to implicated drug.
73
Rosai-Dorfman disease: Typical patient.
Child or young adult with bilateral cervical lymphadenopathy.
74
Rosai-Dorfman disease: Other possible signs and symptoms
Fever.
Weight loss.
Leukocytosis.
Anemia.
Elevated ESR.
75
Rosai-Dorfman disease: Histology (2).
Histiocytes markedly expand the sinuses.
Small lymphocytes and abundant plasma cells accompany the histiocytes.
76
Rosai-Dorfman disease: Cytology
Histiocytes . . .
- Nucleus: Round, with single nucleolus.
- Cytoplasm: Abundant, eosinophilic.
- Emperipolesis, especially of lymphocytes.
77
Rosai-Dorfman disease: Immunohistochemistry (4,2).
Positive: S100, CD14, CD68, CD163.
Negative: CD1a, langerin.
78
Lymph nodes draining prosthetic implants: Histology.
Sinus histiocytes containing coarse refractive matter.
79
Whipple's disease: Initial presentation.
Migratory arthralgia.
80
Whipple's disease: Histology.
Histiocytes distend the sinuses.
Lipogranulomas.
Non-necrotizing granulomas sometimes.
81
Whipple's disease: Special stains (2).
Positive (histiocytes): PAS.
Negative: AFB.
82
Whipple's disease: Best site of biopsy.
Small intestine.
83
Whipple's disease: Ancillary studies (2).
Electron microscopy.
PCR of tissue, stool, or saliva.
84
Lymphadenopathy due to deposition of endogenous lipid material: Sites.
Nodes of porta hepatis.
Celiac lymph nodes.
85
Lymphadenopathy due to deposition of endogenous lipid material: Causes (5).
Mineral oil.
TPN.
Cholesterol.
Fat embolism.
Fat necrosis.
86
Lymphadenopathy due to deposition of endogenous lipid material: Histology (3).
Vacuolated sinus histiocytes.
Extracellular spaces.
Giant cells.
87
Lymphadenopathy due to deposition of endogenous lipid material: Special stain.
Negative: PAS.
88
Kikuchi's disease: Synonym.
Histiocytic necrotizing lymphadenitis.
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