Diagnostic specificity of histologic features in lymph node biopsy specimens from patients at risk for the acquired immunodeficiency syndrome
29
Citation
58
Reference
10
Related Paper
Citation Trend
Keywords:
Follicular hyperplasia
Mantle zone
Lymphoid hyperplasia
Lymph node biopsy
Often, it is difficult to distinguish follicular lymphoma from reactive follicular hyperplasia histologically. Immunotypic evidence of monoclonality cannot be demonstrated routinely or reliably in routine paraffin-embedded sections. To determine whether a panel of monoclonal antibodies reactive with lymphoid cells in paraffin-embedded sections might be useful in distinguishing these confusing proliferations, the authors examined 45 follicular lymphomas and 30 follicular hyperplasias with the following antibodies: L26, B2, MT1, MT2, and UCHL-1. All sections were routine paraffin preparations from formalin- or B5-fixed tissue and were immunostained with the avidin-biotin immunoperoxidase technique. Ninety-two percent of the B5-fixed and 77% of the formalin-fixed lymphomas were MT2 positive. None of the reactive hyperplasias stained positively, and none of the other antibodies demonstrated consistent differences between these benign and malignant proliferations. MT2 marks interfollicular T cells and mantle-zone B cells in normal lymph nodes but does not mark normal germinal centers; this staining pattern is retained in reactive hyperplasia. However, paradoxically, in most follicular lymphomas the neoplastic germinal centers show aberrant MT2 positivity. The authors conclude that MT2 may be useful in distinguishing follicular lymphoma from follicular hyperplasia in paraffin sections.
Follicular hyperplasia
Follicular lymphoma
Lymphoid hyperplasia
Mantle zone
Immunoperoxidase
Cite
Citations (23)
Objective To describe the histologic features of lymph nodes adjacent to hyaline-vascular Castleman disease(HVCD)lesions.Methods Seven cases of HVCD in which adjacent lymph nodes were available were identified.H-E stained sections were examined and immunohistochemical staining was performed.Results All the lymph nodes had preserved sinuses,and showed many follicles.Most follicles had small or no germinal centers,and presented apparently prominent mantle zones.However,in immunostaining for mantle cells(lgD),mantle zones were genuinely thickened in 3 cases;most follicles actually showed marginal zone rather than mantle zone hyperplasia.Occasional regression of germinal center(5 cases),onion-skining of mantle zone(2 cases),hyaline vessels in germinal center(1 case)and follicles with multiple germinal centers(1 case)were identified in this group.In interfollicular zone,prominently hyperplasia of high endothelial venules were not observed.Conclusions Lymph nodes adjacent to HVCD lesions can show some incompletely developed features of HVCD and follicles with apparently thick mantle zone.The findings of these features in lymph nodes may prompt the possibility of nearby HVCD if a small lymph node adjacent to a large lesion is biopsied.
Mantle zone
Hyaline
Follicular hyperplasia
Cite
Citations (0)
Lymph node enlargement is common in active systemic lupus erythematosus (SLE), a disease that is characterized by well‐defined clinical criteria. Histologically, although lymphadenopathy associated with SLE exhibits marked histological diversity and occasionally shows atypical lymphoproliferative disorders, there has not been any description of the histopathological features of reactive lymph node hyperplasia with giant follicles (RHGF). We here report three such cases. The subjects were a 23‐year‐old Japanese female, a 44‐year‐old Japanese female and a 49‐year‐old Japanese male. All three patients initially presented with systemic lymphadenopathy. They also had systemic symptoms and abnormal laboratory findings indicating active disease, although two patients did not fulfill the diagnostic criteria for SLE at lymph node biopsy. Histologically, three lesions were characterized by numerous enlarged, coalescing lymphoid follicles with distortion rather than effacement of the lymph node architecture. By in situ hybridization, Epstein‐Barr virus (EBV) genomes were demonstrated in two cases. The present three cases indicate that lymphadenopathy associated with SLE representing RFGH should be differentiated from the early stage of HIV‐related lymphadenopathy as well as follicular lymphoma, particularly the floral variant. The authors would like to stress that the RHGF which is described in the present study should be listed in the pathohistology of SLE lymphadenopathy.
Follicular hyperplasia
Lymphoid hyperplasia
Lymph node biopsy
Lymphoproliferative Disorders
Cite
Citations (12)
Follicular hyperplasia
Mantle zone
Lymphoid hyperplasia
Lymph node biopsy
Cite
Citations (0)
Follicular hyperplasia
Lymphoid hyperplasia
Cite
Citations (7)
No AccessJournal of Urology1 Mar 1986Primary Lymph. Node Pathology in AIDS and AIDS- Related Lymphadenopathy E.P. Ewing, F.W. Chandler, T.J. Spira, R.K. Brynes, and W.C. Chan E.P. EwingE.P. Ewing More articles by this author , F.W. ChandlerF.W. Chandler More articles by this author , T.J. SpiraT.J. Spira More articles by this author , R.K. BrynesR.K. Brynes More articles by this author , and W.C. ChanW.C. Chan More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)45811-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Primary Lymph. Node Pathology in AIDS and AIDS- Related Lymphadenopathy." The Journal of Urology, 135(3), p. 665 © 1986 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 135Issue 3March 1986Page: 665 Advertisement Copyright & Permissions© 1986 by The American Urological Association Education and Research, Inc.MetricsAuthor Information E.P. Ewing More articles by this author F.W. Chandler More articles by this author T.J. Spira More articles by this author R.K. Brynes More articles by this author W.C. Chan More articles by this author Expand All Advertisement PDF downloadLoading ...
Cite
Citations (6)
Follicular hyperplasia
Mantle zone
Lymphoid hyperplasia
Lymph node biopsy
Cite
Citations (29)
Lymph nodes of patients symptomatically infected with the acquired immunodeficiency syndrome (AIDS) virus show a spectrum of morphologic changes ranging from marked lymphoid hyperplasia to marked lymphocytic depletion. These changes can be grouped into three distinct patterns. The type I pattern features follicular and paracortical hyperplasia, and is associated with chronic lymphadenopathy. The type II pattern, which shows diffuse lymphoid hyperplasia but loss of germinal centers, signifies evolution of chronic lymphadenopathy to AIDS. The type III pattern shows marked lymphocytic depletion and represents the end-stage lymph node seen in fatal AIDS. These histologic patterns are closely correlated with the clinical and immunologic status of patients infected with the AIDS virus.
Follicular hyperplasia
Lymphoid hyperplasia
Generalized lymphadenopathy
Lymphatic disease
Cite
Citations (62)
Histologically, the marginal zone pattern of the lymph node is characterized by lymphoid follicles with three distinct layers. The inner layer is composed of follicular center zones, the middle layer of darkly stained mantle zones, and the outer layer of marginal zones. However, the marginal zone pattern is rarely seen in reactive lymph nodes except for mesenteric lymph nodes. We describe the clinicopathologic, immunohistochemical and genotypic findings of six cases of reactive follicular hyperplasia exhibiting the marginal zone pattern. The patients comprised three males and three females (age range 24 to 63 years; medium 56 years). Follow-up data were obtained from five patients. None of them developed malignant lymphomas during the follow-up period of from 5 to 204 months (median 68 months). Histologically, the lesion was characterized by numerous lymphoid follicles and partial distortion of lymph node structure. Varying degrees of progressive transformation of the germinal center (PTGC) were noted in the four cases. The marginal zone pattern was observed in some or most of the lymphoid follicles including PTGC. The marginal zone B cells were small to medium-sized lymphocytes with round or slightly indented nuclei and a broad rim of pale cytoplasm. Some of them had a monocytoid appearance. They were CD20+, CD79a+, sIgM+/-, sIgD-, CD5-, CD10-, CD21-, CD23-, CD43-, CD45RO-, Bcl-6-, cyclin D1-, EMA- and p53-. A portion of them were Bcl-2 positive. Occasional large lymphoid cells with round or indented nuclei and moderate amounts of cytoplasm were observed in the marginal zone in four cases. These large lymphoid cells were usually CD20 positive, but Bcl-6 negative. A small number of them contained polytypic intracytoplasmic immunoglobulins. The polytypic nature of B lymphocytes was demonstrated by immunohistochemistry and polymerase chain reaction. Recognition of unusual marginal zone hyperplasia in reactive lymph node lesions is important to avoid confusion with nodal involvement in various low-grade B cell lymphomas presenting a marginal zone distribution pattern.
Mantle zone
Follicular hyperplasia
CD5
CD23
Cite
Citations (13)
Mantle zone
Follicular hyperplasia
Lymphoid hyperplasia
Pseudolymphoma
Lymph node biopsy
Cite
Citations (2)