Benign Lymphadenopathy

  1. Which is worse, B/L and tender LN, or unilateral and nontender LN?
    U/L nontender
  2. LN neoplasm cytology
    • nuclear pleomorphism,
    • mitotic figures,
    • prominent nucleoli,
    • prominent nuclear membranes,
    • prominent nuclei,
    • variety of nuclear irregularities
  3. Reactive LN cytology
    pronounced mitotic activity due to high turnover, but not the same degree of pleomorphism
  4. Vary in size, shape and number of follicles; seen
    often in children and adolescents
    Follicular hyperplasia-nonspecific
  5. Tingible body macrophages
    Reactive hyperplasia
  6. Unilateral posterior lymph nodes are commonly affected
    Toxoplasmosis lymphadenitis
  7. What are LN characteristics in toxoplasmosis lymphadenitis?
    • Reactive follicular hyperplasia
    • Small aggregates of epithelial histiocytes
    • Monocytoid B-cell hyperplasia
    • Epithelioid clusters encroach on follicles
    • Monocytoid B-cells seen in subcapsular and trabecular sinuses of the lymph nodes
  8. What cells are predominant in toxoplasmosis lymphadenitis?
    B cells
  9. Associated with plasma cells and perivascular location
  10. Epithelial histiocytes, thick capsule of the lymph node, with plasmacytic and lymphocytic infiltrate
    Follicular hyperplasia-syphilis
  11. When are spirochetes present in blood vessels in syphilis?
    Early stages
  12. Solitary inguinal lymphadenopathy
  13. Four types of granulomatous lymphadenitis
    • Kikuchi disease
    • Cat scratch disease
    • Lymphogranuloma venereum
    • Sarcoidosis
  14. Necrosis and aggregates of macrophages with “C” shaped nuclei and CD8+ immunoblasts in interfollicular areas
    Kikuchi dz
  15. Necrotic areas with karyorrhectic debris and paucity (low number) of neutrophils
  16. Plasmacytoid monocytes with round nuclei and eosinophilic cytoplasm
  17. What population does Kikuchi dz affect?
    young women
  18. Kikuchi dz is similar to what other dz?
  19. Discrete well circumscribed, non-caseating epitheliod granulomas
  20. Asteroid and Schaumen bodies
    Sarcoidosis (although they are NOT pathonogmonic and sarcoid is a dx of exclusion)
  21. Suppurative (pus) granulomas with stellate (star-shaped) abscesses surrounded by pallisading macrophages and histiocytes especially in germinal centers
    Cat scratch dz
  22. What type of hyperplasia is evident in cat-scratch dz?
  23. Cause of cat-scratch
    Bartonella Hensale
  24. Found in immunocompromised hosts with dermal lesions, increased capillaries, plump endothelial cells, granular eosinophilic material containing the organism
    Bacillary angiomatosis
  25. Negative silver stain
    Lymphogranuloma venereum
  26. Inguinal lymphadenopathy, presence of chlamydia, hx of sexual activity and burning with urination
    Lymphogranuloma venereum
  27. Lymphogranuloma venereum resembles what?
    Cat scratch disease
  28. Extravasation of RBC’s into the germinal centers, mantle zones are the areas around the follicles
    HIV related hyperplasia
  29. cells with multiple nuclei and eosinophilic intranuclear inclusions
    Warthin-Finkeldy cells, associated with HIV related hyperplasia
  30. Follicular hyperplasia florid and termed explosive
    HIV related hyperplasia
  31. geographic pattern/geographic follicles
    HIV associated hyperplasia
  32. What can cause a diffuse pattern?
    • Mono
    • Postvaccinial lymphadenitis
    • Dilantin Hypersensitivity
  33. Reactive follicles with marked interfollicular expansion and mottled appearance (slightly resembling Reed Sternberg cells)
  34. Mottled vascular mixed cell infiltrate
    Post vaccinal lymphadenitis
  35. Fever, erythematous rash and eosinophilia
    Dilantin sensitivity
  36. Prominent lymphocytic hyperplasia with a background of macrophages
    Viral lymphadenitis
  37. Follicular hyperplasia, interfollicular plasmacytosis similar to syphilis
  38. Having RA puts you at risk for what?
  39. Which form of castleman disease is more common?
    Hyaline vascular form
  40. Mantle zone hyperplasia with concentric layering of cells giving an onionskin pattern
    Castleman Disease
  41. Vessels penetrate into the germinal center resembling a lollipop
    Castlemad Disease
  42. Two or more germinal centers with hyalinized vessels
    Castleman Dz
  43. Herpes virus 8 is linked to what conditions
    Multicentric castleman and kaposi sarcoma
  44. sinus histiocytosis with massive lymphadenopathy (B/L nontender cervical nodes)
  45. Histiocytes, S100+, macrophages with emperipolesis
  46. Nodes matted together from fibrosis (over months to years)
    Rosai Dorfman
  47. Foamy macrophages and sickle shaped bacillary organisms
    Whipple Disease
  48. Hyperpigmentation of the skin with CNS changes – depression, stupor, confusion
    Whipple Disease
  49. Chief complaint in a Whipple Dz pt
  50. Younger children with pancytopenia and constitutional symptoms
    Virus associated hemophagic syndrome
  51. Bland macrophages seen in lymph nodes; macrophages ingest RBC, neutrophils, and platelets
    Virus associated hemophagic syndrome
  52. Paracortical/interfollicular expansion of large cells
    Dematopathic lymphadenitis
  53. Pigment laden macrophages, similar to mycosis fungoides or lymphoma
    Dermatopathic lymphadenitis
  54. Lymphadenopathy, splenomegaly; hypergammaglobulinemia
  55. Genetic type mutation of FAS(CD95),generally activates apoptosis
  56. Increase CD5+ B cells in peripheral blood
  57. Paracortical follicular hyperplasia with transformation
    of germinal centers
  58. ALPS pts have an increased risk for what?
  59. Give the example of a lymphoproliferative DO with the potential to turn into a lymphoma
  60. Kawasaki Disease is AKA what?
    Mucocutaneous lymph node syndrome
  61. Conjunctivitis, coronary artery involvement, affects kids
  62. Nodal architecture obliterated, lymphoid depletion and absence of follicles
Card Set
Benign Lymphadenopathy
for upcoming path final