1/65. Systemic lupus erythematosus and Castleman's disease.Lymphadenopathy is a common finding in systemic lupus erythematosus (SLE), yet lymphoid malignancy is rare. Typically, adenopathy associated with SLE responds to glucocorticoid therapy. We evaluated a patient with a diagnosis of SLE who had progressive lymphadenopathy despite receiving aggressive corticosteroid therapy for SLE associated thrombocytopenia. Histopathology initially revealed an aggressive plasmacytosis characteristic of Castleman's disease (CD). CD, or angiofollicular hyperplasia, is a rare lymphoproliferative neoplasm that has features overlapping many autoimmune diseases. This disorder should be considered in autoimmune diseases with unremitting or progressive adenopathy.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
2/65. actinomyces and actinobacillus actinomycetemcomitans-actinomyces-associated lymphadenopathy mimicking lymphoma.We present 2 unusual cases of long-standing, extensive reactive lymphadenopathy secondary to actinomyces infection, 1 of which was also accompanied by actinobacillus actinomycetemcomitans-actinomyces complex infection. To our knowledge, histologic features of lymph node involvement by these organisms have not been previously reported in the literature. One patient had extensive cervical, posterior mediastinal, and abdominal lymphadenopathy. The second patient presented with a submandibular mass and cervical lymphadenopathy. Clinical features strongly suggested lymphoma. The histologic examination of the lymph nodes from both patients revealed reactive follicular hyperplasia, marked interfollicular and capsular fibrosis, and multiple interfollicular microabscesses. Characteristic actinomyces colonies were identified at the center of the microabscesses in deep sections. Cultures were obtained from the lymph nodes of 1 patient, and were positive for A actinomycetemcomitans. Both patients had poor dental hygiene. Lymphadenopathy subsided with antibiotic therapy and appropriate dental care.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
3/65. The heterogeneity of Castleman disease: report of five cases and review of the literature.Castleman disease (CD; angiofollicular lymphoid hyperplasia) is a heterogeneous group of lymphoproliferative disorders of uncertain cause. Three histologic variants (hyaline vascular, plasma cell, and mixed) and two clinical types (localized and multicentric) of CD have been described. We report 5 cases of CD treated in our institute and review the literature about the management of this relatively rare disorder. Localized and multicentric CD may be different clinical disorders with overlapping histologic features. Localized disease generally presented with a single enlarged lymph node or widening of the mediastinum, whereas multicentric disease is a systemic lymphoproliferative disorder characterized by lymphadenopathy, hepatosplenomegaly, constitutional symptoms, anemia, hypoalbuminemia, and hypergammaglobulinemia. Unlike the localized type, for which surgical excision is curative regardless of the histologic type, multicentric disease often necessitates aggressive systemic therapy and portends a poorer outcome.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
4/65. Subcutaneous angiolymphoid hyperplasia (Kimura disease). Report of a case.A subcutaneous mass removed from the cheek showed histologic features of subcutaneous angiolymphoid hyperplasia (Kimura disease) at its early stage. The condition shows a wide spectrum of pathologic changes. At its early stage, the main findings consist of active vascular proliferation with plump endothelial cells and varying degrees of lymphocytic, histiocytic, and eosinophilic infiltration. The lesion at its later stage features hyperplastic blood vessels with inconspicuous endothelial cells, well-formed lymphoid follicles, and varying degrees of lymphocytic and eosinophilic infilitration. Blood eosinophilia is frequently seen. review of the literature and study of our own case strongly suggest that this disease is a distinct clinical and pathologic entity.- - - - - - - - - - ranking = 5keywords = hyperplasia (Clic here for more details about this article) |
5/65. ethosuximide induced lymphadenopathy--a case report.A wide range of adverse effects has been reported following prolonged use of anticonvulsant drugs. More commonly reported adverse effects for ethosuximide include gastric disturbances, psychiatric disorders and Systemic Lupus Erythematosus (SLE). Rare instances of leukopenia and pancytopenia have been noted. A case is presented of a 12 year old girl who developed generalized lymphadenopathy with progressive weight loss and leukopenia following prolonged use of ethosuximide for simple absence seizures. The enlarged lymph nodes regressed with withdrawal of the drug but re-appeared when the drug was recommenced. sodium valproate was then introduced and ethosuximide discontinued. The seizures were successfully controlled with sodium valproate. Histopathology report of the lymphnode biopsy showed marked reactive lymphnode hyperplasia.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
6/65. Lymph node lesion in adult-onset Still's disease resembling peripheral T-cell lymphoma: a report of three cases.adult-onset Still's disease (AOSD) is known to be a cause of fever of unknown origin. We describe the clinicopathologic, immunohistologic, and genotypic features of 3 patients with lymph node lesions from AOSD, which posed a serious diagnostic difficulty from peripheral T-cell lymphomas. The patients were 22-, 26-, and 63-year-old Japanese women. At the onset of disease, all patients had multicentric lymphadenopathy in association with clinical and laboratory findings suggestive of a malignant lymphoma. None of the patients developed malignant lymphomas during the follow-up period. Histologically, the lesions were characterized by paracortical hyperplasia with prominent vascular proliferation. In the paracortical area, there was a mixed infiltrate including small-to-medium-sized lymphocytes, variable numbers of eosinophils, plasma cells, and B immunoblasts. polymerase chain reaction analysis demonstrated that neither clonal rearrangement of the T-cell receptor gamma-chain gene nor immunoglobulin heavy-chain rearrangement was detected in any patient. Although AOSD appears to be a rare systemic inflammatory disorder, the lymph node lesion should be added to the differential consideration of benign lymph node lesions simulating node-based peripheral T-cell lymphoma.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
7/65. Erythrodermic syringotropic cutaneous T-cell lymphoma.Syringotropic cutaneous T-cell lymphoma (CTCL) is a rare localized variant of CTCL, characterized histologically by eccrine gland and ductal hyperplasia surrounded by a dense syringotropic lymphocytic infiltrate. Previously reported only in men, we describe the first woman with syringotropic CTCL. Unusually, she presented with erythroderma, cutaneous nodules, poikilodermatous patches, widespread alopecia and lymphadenopathy.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
8/65. Transient posttransplant graft-versus-host lymphadenopathy.There is sparse information in humans on graft-versus-host (GVH) lymphadenopathy. A 15-month-old male received a liver and small bowel transplant for short bowel after gastroschisis. At 21 days he developed a GVH-like skin rash. flow cytometry demonstrated 16.1% circulating donor cells. polymerase chain reaction for Epstein-Barr virus was negative. Two months later, the rash recurred with diffuse lymphadenopathy. Lymph node biopsy showed effaced architecture without visible follicles, large numbers of CD79a( ) immunoblasts interspersed with smaller CD3( ) and CD8( ) cells, and prominent dendritic cell hyperplasia. Human herpes virus 8, cytomegalovirus, and EBER-1 probes were negative, as was polymerase chain reaction for human herpes virus 6. Allograft intestinal biopsies on days 10 and 24 had a similar infiltrate. The features appeared to be those of lymphocytes trafficking between the graft and host with a mixed lymphocyte reaction in situ, a GVH-type reaction without tissue damage. The reaction was self-limiting in the intestinal graft, and the lymphadenopathy resolved with some decrease in immunosupression. Circulating donor cells fell to 2.5% by day 62, and the child has been rejection free on low-dose immunosuppression.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
9/65. Expanded populations of surface membrane immunoglobulin light chain-negative B cells in lymph nodes are not always indicative of B-cell lymphoma.Immunophenotypic analysis is useful in distinguishing reactive from neoplastic lymphoproliferations, particularly when tissue is limited or histologic findings are equivocal. Surface membrane immunoglobulin (SmIg) light chain restriction in B cells is especially helpful in documenting clonality, and the loss of SmIg by B cells in extramedullary sites also has been used as a criterion to support the presence of lymphoma. However, we identified 3 cases of benign follicular hyperplasia (in 101 cases analyzed) with profound expansions (56%-88% of the B cells) of SmIg light chain-negative B cells without clonality by immunoglobulin heavy chain gene polymerase chain reaction. Thus, although uncommonly encountered, lack of SmIg light chain expression by B cells should not necessarily be interpreted as indicative of lymphoma. Interestingly, 2 of the 3 patients with these "aberrant" expansions were hiv , and such patients are at heightened risk for the development of lymphoma. Therefore, there is the potential for misdiagnosing lymphoma if flow cytometric data are interpreted inappropriately in isolation.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
10/65. A case of thoracic hemorrhage due to ectopic parathyroid hyperplasia with chronic renal failure.We report a case of secondary hyperparathyroidism in a 53-year-old man who had thoracic hemorrhage originating from an ectopic thymic parathyroid gland tumor. He was on long-term hemodialysis treatment and had persistent secondary hyperparathyroidism caused by 3 swollen parathyroid glands around the thyroid gland and a mediastinal ectopic parathyroid gland tumor. parathyroidectomy and removal of the mediastinal tumor were planned. Preoperative chest x-ray and a computed tomographic scan obtained just before surgery showed left pleural effusion. Furthermore, diagnostic thoracentesis yielded hemorrhagic exudative fluid. thoracoscopy confirmed the presence of a mediastinal tumor lesion that was bleeding into the thoracic cavity. The tumor was resected using thoracoscopic surgery, and ectopic thymic parathyroid gland hyperplasia associated with hemorrhage was pathologically diagnosed. A postoperative diagnostic chest computed tomographic scan and technetium 99m 2-methoxyisobutyl isonitrile scintigraphy showed successful removal of the ectopic parathyroid gland tumor. Subsequently, the secondary hyperparathyroidism could be clinically controlled by medical treatment, and total parathyroidectomy has been postponed indefinitely. We consider that hemorrhage from the ectopic parathyroid gland tumor resulted in thoracic bleeding. To our knowledge, this is the first case report of secondary hyperparathyroidism with thoracic hemorrhage originating from an ectopic mediastinal parathyroid gland.- - - - - - - - - - ranking = 5keywords = hyperplasia (Clic here for more details about this article) |
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