Difference between revisions of "Lymph node pathology"
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*"Lollipops" - germinal centers fed by prominent vessels; lollipop-like appearance. | *"Lollipops" - germinal centers fed by prominent vessels; lollipop-like appearance. | ||
*Two germinal centers in one follicle. | *Two germinal centers in one follicle. | ||
==Cat-scratch disease== | |||
===General=== | |||
*[[AKA]] ''Cat-scratch fever'', | |||
*Infection caused by spirochete ''Bartonella henselae''.<ref name=pmid19332922>{{Cite journal | last1 = Jerris | first1 = RC. | last2 = Regnery | first2 = RL. | title = Will the real agent of cat-scratch disease please stand up? | journal = Annu Rev Microbiol | volume = 50 | issue = | pages = 707-25 | month = | year = 1996 | doi = 10.1146/annurev.micro.50.1.707 | PMID = 8905096 }}</ref> | |||
*Treatment: antibiotics. | |||
===Micrograph=== | |||
Features: | |||
*Palisading granulomas with neutrophils in the center. | |||
Stains: | |||
*Warthin-Starry stain. | |||
Image(s): | |||
*[http://www.webpathology.com/image.asp?case=386&n=1 Cat-scratch disease (webpathology.com)]. | |||
*[http://www.webpathology.com/image.asp?n=2&Case=386 Cat-scratch disease - high mag. (webpathology.com)] | |||
==See also== | ==See also== | ||
Revision as of 03:14, 18 June 2010
This article deals with lymph node pathology. An introduction to the lymph node is in the lymph nodes article.
Kikuchi disease
General
- AKA histiocytic necrotising lymphadenitis (HNL).[1]
- Rare disease that may mimic cancer, esp. lymphoma.
- May cause fever & systemic symptoms.[2]
Epidemiology:[2]
- Usually <40 years old.
- Asian.
- Female:Male = 3:1.[3]
Treatment:
- Usually self-limited.[2]
- Oral corticosteroids.
DDx:
- Non-Hodgkin lymphoma.
- Systemic lupus erythematosus.
Micrograph
Features (the three main features - just as the name suggests):[4]
- Histiocytes.
- May be crescentic.
- Necrosis (due to apoptosis) - paracortical areas.[2]
- Necrosis without neutrophils - key feature.
- Lymphocytes (CD8 +ve).
- Plasmacytoid dendritic cells.
Notes:
- Dendritic cell - vaguely resembles a macrophage:[5]
- Long membrane projections - key feature.
- Abundant blue-grey cytoplasm, +/- ground-glass appearance.
- Nucleus: small, ovoid, usu. single nucleolous.
Images:
IHC
- CD68 +ve.
- CD8 +ve.
- CD4, CD20, CD3, and CD30 - mixed.
- Done to excluded lymphoma; should show a mixed population of lymphocytes.
Castleman disease
General
- Benign. (???)
Microscopic
Features:[6]
- Pale concentric mantle zone lymphocytes.
- "Lollipops" - germinal centers fed by prominent vessels; lollipop-like appearance.
- Two germinal centers in one follicle.
Cat-scratch disease
General
- AKA Cat-scratch fever,
- Infection caused by spirochete Bartonella henselae.[7]
- Treatment: antibiotics.
Micrograph
Features:
- Palisading granulomas with neutrophils in the center.
Stains:
- Warthin-Starry stain.
Image(s):
See also
References
- ↑ Kaushik V, Malik TH, Bishop PW, Jones PH (June 2004). "Histiocytic necrotising lymphadenitis (Kikuchi's disease): a rare cause of cervical lymphadenopathy". Surgeon 2 (3): 179–82. PMID 15570824.
- ↑ 2.0 2.1 2.2 2.3 Hutchinson CB, Wang E (February 2010). "Kikuchi-Fujimoto disease". Arch. Pathol. Lab. Med. 134 (2): 289–93. PMID 20121621.
- ↑ URL: http://emedicine.medscape.com/article/210752-overview. Accessed on: 3 June 2010.
- ↑ URL: http://www.ispub.com/journal/the_internet_journal_of_head_and_neck_surgery/volume_1_number_1_30/article_printable/kikuchi_s_lymphadenitis_in_a_young_male.html. Accessed on: 1 June 2010.
- ↑ URL: http://www.healthsystem.virginia.edu/internet/hematology/hessedd/benignhematologicdisorders/normal-hematopoietic-cells/dendritic-cell.cfm?drid=214. Accessed on: 3 June 2010.
- ↑ URL: http://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_9_number_2_11/article/a_rare_case_of_castleman_s_disease_presenting_as_cervical_neck_mass.html. Accessed on: 15 June 2010.
- ↑ Jerris, RC.; Regnery, RL. (1996). "Will the real agent of cat-scratch disease please stand up?". Annu Rev Microbiol 50: 707-25. doi:10.1146/annurev.micro.50.1.707. PMID 8905096.