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Lymph node pathology. Lymph node histology. Functions Filtration of lymph Processing of Ag Differentiation of lymphocytes. Secondary lymphoid follicle Germinal centre mantle. Terminology. Lymphadenopathy Lymphadenomegaly Lymphadenitis Lymphoproliferation Lymphoma
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Lymph node histology Functions Filtration of lymph Processing of Ag Differentiation of lymphocytes
Secondary lymphoid follicle Germinal centre mantle
Terminology • Lymphadenopathy • Lymphadenomegaly • Lymphadenitis • Lymphoproliferation • Lymphoma • Enlargement of LN: inflammation • Tumor – primary/secondary
Lymphadenitisacute or chronic Classification predominant histologic pattern etiology Rarely biopsied
Lymphadenitis - etiology MICROBIAL • viral • bacterial, mycobacterial • fungal • protozoal NONMICROBIAL - autoimmune storage dis. foreign mat. miscel.
Lymph node inflammation Lymph node hyperplasia: 1. follicular 2. paracortical 3. sinuses 4. mixed patterns
Lymph node inflammation - patterns • Follicular hyperplasia bacteria, RA, HIV(early), syphilis, Castleman dis. • Paracortical hyperplasia viruses, dermatopathies, vaccination, drug hypersensitivity, Kikuchi, SLE, draining pus or carcinoma
Lymphadenitis - histological patterns • sinusoidal hyperplasia - lymphangiography, Whipple dis., sin. histiocytosis with massive lymphadenopathy, draining carcinoma • granulomas - TB, other mycobact., leprosy, Whipple, fungi, berylliosis, sarcoidosis, • Granulomatous-purulent:cat scratch, tularemia, lymphogr. venereum,Yersinia • mixed patterns: toxoplasmosis
Sinus histiocytosis with massive lymphadenopathy