Angio-immunoblastic lymphadenopathy: A clinical, immunological and molecular study
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Keywords:
Hepatosplenomegaly
Generalized lymphadenopathy
Lymph node biopsy
Summary and Conclusions A homogenate of rat lymph node was injected into rabbits to stimulate production of antirat lymph node antibodies. The rabbit globulin was radioiodinated and adsorbed on and eluted from rat lymph node homogenate. The product was tested in vitro by precipitation tests against various organ homogenates, and radioassays showed the presence of labeled antilymph node antibodies. The data from the rats injected subcutaneously and serially sacrificed showed the presence of labeled antibodies which localized in lymph nodes more than did labeled antikidney antibodies or labeled globulin from normal serum. Labeled antilymph node antibodies localized in spleen and mesenteric lymph nodes more than did labeled antikidney antibodies or labeled globulin from normal serum. In this experiment, antibodies prepared against lymphatic tissue differed qualitatively from other proteins in their lymphatic tissue localization. An alternative method of preparation was employed in which antibody separation was followed, rather than preceded, by isotope labeling. Antibodies so labeled were injected intravenously and subcutaneously for an in vivo test similar to the previous experiment. Intravenous injection resulted in maximum antibody localization in spleen. Subcutaneous injection resulted in maximum antibody localization (up to 25% of the significant dose) at the injection site and the lymph nodes which drained it. As is well known, lymphatic tissue is scattered throughout the body with some portions lying well below the skin and not easily found. A technique for tracing the tissues of this system would provide information to immunologists tracing antigen-antibody combinations, and, conceivably, to surgeons performing radical lymph node dissections. The data presented are consistent with the hypothesis that lymph nodetissue specific antibody had been prepared and labeled and that the antibody, when injected, traced the lymphatic flow of the animal.
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Rat mesenchymal renal tumor cells (NeDe) transplanted under the kidney capsule of F344 rats resulted in metastases in the parathymic lymph nodes. Tumor cells were isolated from these tumor-bearing lymph nodes and 106 cells were implanted under the kidney capsule. Tumor growth after this implantation could be traced within six days. India ink was implanted to prove that there is a connection between the lymphatic vessels of the kidney capsule and the parathymic lymph nodes. The distribution of the radioligand 18FDG in different organs also provided evidence that the parathymic lymph nodes are the primary sites of metastatic tumor growth. Tumor growth was followed after staining sections of biopsies of normal, tumorous kidneys and parathymic lymph nodes embedded in paraffin. The progression of tumor formation was seen as a frontline between the healthy and tumor bearing tissue. This demarcation line was sharp at the beginning of the invasion and at the peripheral regions of the tumor, while the central region infiltrated into the healthy kidney tissue. The initial invasion gradually turned to an infiltration resulting in the disruption of the renal tissue, especially at the periphery. Accumulation of lipids and flow of blood to the lymphatic vessels was due to the lack of angiogenesis, leading to an increased pressure of the interstitial fluid. Interstitial damage ultimately led to the appearance of blood and the growth of tumor cells in parathymic lymph nodes. The kidney capsule-parathymic lymph node complex is proposed as a suitable metastatic model for the isolated in vivo examination of tumor development and for the analysis of secondary tumors.
Renal capsule
Primary tumor
Infiltration (HVAC)
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Abstract Telomerase activity (TA) and the expression of p16 INK4 , telomerase reverse‐transcriptase catalytic subunit (TERT) and proliferating cell nuclear antigen (PCNA) were analysed in lymph nodes from clinically normal dogs and from dogs with lymphoma. Telomere lengths were measured in 12 histologically normal lymph nodes. These data were related to the overall survival time of the lymphoma patients given chemotherapy, in an effort to identify prognostic significance of the measured variables. There was no significant difference between TA of normal lymph nodes ( n = 16) and lymphoma lymph nodes ( n = 6). PCNA expression was significantly higher in lymphoma ( n = 30) than in normal lymph nodes ( n = 10), but TERT expression was not. Expression of p16 INK4 was not significantly different between normal and lymphoma lymph nodes. TA and p16 INK4 expression were inversely correlated within the normal lymph nodes studied. Telomere lengths in normal lymph nodes were consistent with previous studies. No variables examined had any correlation with survival of the lymphoma patients given chemotherapy. The role of p16 INK4 in the regulation of TA warrants further investigation.
Canine Lymphoma
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Infiltration (HVAC)
Immunoelectron microscopy
Generalized lymphadenopathy
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Objective To discuss the early diagnostic significance of lymph node puncture and biopsy for HIV/AIDS patients with superficial lymph nodes.Method Clinical manifestations and the data of laboratory,radiological,endoscopic and pathological examinations of 43 HIV/AIDS patients with superficial lymph node were reviewed and their treatment regimes and the prognosis were analyzed.Results ① Gender ratio was 9.8:1(male: female),with an average age of 33.6 years.②76.7% of the patients(33/43) had lymph node enlargement before HAART(highly active antiretroviral therapy);while 20.9% of them(9/43)had lymph node enlargements within five months after HAART.③ Clinical manifestation: 88.4% of the patients(38/43)had fever,48.8%(21/43)experienced weight loss,40.0%(17/43)had either coughing and expectoration or night sweating;90.7%(39/43) had enlargement of head and neck lymph nodes;86.0%(37/43)had lymph nodes enlargement at multiple locations;86.0%(37/43)had enlarged lymph nodes with diameter between 1-5 cm.④Laboratory examination: 81.4% of the patients(35/43)had anemia;48.8%of the patients(21/43)had CD+4 T-lymphocyte count less than 50/μl;7.0%(3/43)had CD+4T lymphocyte count between 50-100/μL;and 86.0%(37/43)had accelerated ESR.⑤Diagnostic examination: 65.1% of the patients(28/43)had deep swollen lymph nodes;32.6%(14/43)had hepatosplenomegaly;30.2%(13/43)had pulmonary tuberculosis.⑥ Pathology of lymph node biopsy: 58.1% of the patients(25/43) had mycobacteria infection;11.6%(5/43)had Penicillosis marneffei(PSM);and 11.6%(5/43)had AIDS-related lymphoma(ARL).⑦ Prognosis: Most of the patients had good prognosis,except the ARL patients.Conclusion The clinical manifestations of HIV/AIDS patients with superficial lymph node are highly different.Mycobacteria and fungus infections and tumors are commonly seen.Early histo-cytological examination via lymph node puncture or biopsy plays an important role in early diagnosis and treatment.
Lymph node biopsy
Hepatosplenomegaly
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The pattern of lymph node involvement in Waldenström's macroglöbulinemia (MG) is described according to clinical and histological materials from 2 biopsy and 4 autopsy cases. The histological features of biopsy were well‐differentiated, diffuse, lymphocytic lymphoma in one case (case 1) and sinus histiocytosis (SH) with nodular aggregates of lymphoid cells as observed by the first biopsy in the other case (case 2). An immunofluorescent study of lymph nodes revealed monoclonal proliferation of B lymphocytes (IgM, κ) in both cases. In case 2, a majority of circulating lymphoid cells bore membrane‐bound monoclonal IgM. The histological features of lymph nodes obtained by the second biopsy in case 2 was comparable with the well‐differentiated, lymphocytic lymphoma in some nodes, and diffuse and nodular proliferation with preservation of sinuses in the other nodes. The pattern of lymph node involvement of 4 autopsy cases were also analysed. According to these investigations, It is suggested that lymph node showing SH is a pattern of lymph node involvement of MG.
Lymph node biopsy
Macroglobulinemia
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A 6-year-old child developed generalized lymphadenopathy and hepatosplenomegaly 2 weeks after diphenylhydantoin therapy was begun. The patient recovered 4 weeks after discontinuance of the drug therapy. There was eosinophilia in blood and in bone marrow, and a lymph node biopsy specimen showed reticulum and lymphoid hyperplasia.
Hepatosplenomegaly
Generalized lymphadenopathy
Lymph node biopsy
Lymphoid hyperplasia
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To study the value of contrast-enhanced ultrasound in tuberculous cervical lymph node biopsy.Seventy-nine patients with cervical lymph node were divided into two groups. The lymph nodes of group A were used as real-time ultrasound guided biopsy; the lymph nodes of group B were contrast-enhanced ultrasound firstly to determine the target lymph node and the puncture point, then were detected with needle biopsy.Group A: for the 23 lymph nodes of 23 patients, the rate of intact tissue was 52.1% and the positive rate of pathological diagnosis was 73.9%. Group B: for the 56 lymph nodes of 56 patients, the rate of intact tissue was 98.2% and the positive rate of pathological diagnosis was 100% (Chi square value was 23.37 and 12.31, P < 0.05).The application of contrast-enhanced ultrasound before cervical lymph node biopsy can obviously improve the rate of intact tissue and the positive rate of pathological diagnosis.
Lymph node biopsy
Cervical lymph nodes
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Fine needle aspiration (FNA) diagnosis of Langerhans cell histiocytosis (LCH) of the lymph nodes has been described rarely.LCH was confined to the lymph nodes in six children. The FNA smears showed high cellularity composed of many isolated Langerhans cells (LCs) with nuclear grooves and intranuclear inclusions. Also seen were numerous eosinophils, lymphocytes, giant cells, dendriticlike cells, macrophages and Charcot-Leyden crystals in a background of eosinophilic granules. Immunohistochemical study revealed a positive reaction with S-100 protein.The presence of LCs with nuclear grooves, eosinophils, giant cells and a positive reaction with S-100 protein aided the diagnosis of LCH of the lymph nodes. Charcot-Leyden crystals, intranuclear inclusions and dendriticlike cells were seen in this study. These findings have not been reported before in lymph node FNA smears of LCH.
Langerhans Cell Histiocytosis
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Three cases of non‐Hodgkin's lymphoma, B‐cell type, identical histologically to so called neoplastic angioendotheliosis (NAE), are reported. All showed a rapidly progressive clinical course and were not properly diagnosed before death. The lymphoma cells were distributed in many vessels of systemic organs with a tendency to form aggregates. The primary sites in the three cases were probably the adrenal gland, lymph node, and spleen, respectively. In particular, in one case it was suggested that the lymphoma cells had spread from the adrenal tumor to other organs, showing the histological features of NAE. In the literature, the primary sites of NAE have been scarcely mentioned. However, gross tumors were present in some cases. In such cases, it is possible that the tumors could be the primary sites of NAE. We conclude that some non Hodg‐kin's lymphomas can exhibit the features of NAE during their course, particularly in the terminal stages. Acta Pathol Jpn 42: 272‐278, 1992.
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