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Reactive hyperlasia, cervical lymph node (4248)
Reactive hyperlasia, cervical lymph nodeclosed
Subtitle: 675_2007
Type:
lymph node
Sender:
mona_rashed
2007-12-04 17:56
INCTR - EBMWG Hematopathology Online
Female 25 years old, presented with cervical lymphadenopathy , excision biopsy was done for histopathological study. Pls how to diagnose this case.
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tzankov
2007-12-05 13:15
under reserve of the thikness of the slides, the poor focus of the figures and tha lacking scanning magnification, one can identify a mixture of small lymphoid elemnts, particulalry in sinuses, intermingled with delicate fibrous bands, vessels and "pink" histiocytes. in LN1 a reactive follicle is seen on the right and the one in LN4 has some reminiscense of Castleman onion-skin lesion. considering the morphology, the differential is broad, ranging from unspecific reactive process, through early Castleman to mantle cell lymphoma (particularly the latter should be excluded by immuno - CD20, CD5, CD23, Cyclin D1), naturally, considering the age of the patient, the latter seems also the most unprobable... to sumarize I would favor a reactive process, but particularly mantle cell lymphoma should be ruled out.
SergeyN
2007-12-06 13:44
Most of the images look like paracortical hyperplasia with all usual features: polimorfism, histiocytes, vascularisation. Lymphocte-filled sinuses could indicate viral process.  
 
It is difficult to appreciate follicules: one is hyperplastic, one Castleman-like. If there is a significant follicular hyperplasia in this node, I think a reactive process is most probable.
diane.c.farhi
2007-12-07 22:27
I agree that it is likely a reactive process. Of the views submitted, the low-power ones are the most helpful.
hurwitz
2007-12-10 21:49
I agree with my colleges, reactive hyperplasia, in particular paracortical hyperplasia is the most likely diagnosis.  
A viral etiology is a possibility.  
A neoplastic lymphoproliferation is highly unlikely.
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Last modified: 2007-12-04 17:56:24