Clinical, histopathologic, and immunoarchitectural features of dermatopathic lymphadenopathy: an update

Garcés, Sofía; Yin, C. Cameron; Miranda, Roberto N.; Patel, Keyur P.; Li, Shaoying; Xu, Jie; Thakral, Beenu; Poppiti, Robert; Medina, Ana Maria; Sriganeshan, Vathany; Castellano-Sanchez, Amilcar A.; Khoury, Joseph D.; Garcés, Juan Carlos; Medeiros, L. Jeffrey

doi:10.1038/s41379-019-0440-4

Cited by 21 publications

(27 citation statements)

References 50 publications

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“…(2) Dermatopathic lymphadenopathy is a special type of proliferative lesion of the paracortical region of lymph nodes that usually presents as lymphadenopathy in the drainage area with chronic skin irritation and often shows a pale nodular appearance in the paracortical region, which is mainly composed of proliferating interdigitated dendritic cells, Langerhans cells, and pigment-laden histiocytes. Some studies have shown that in dermatopathic lymphadenopathy lesions [ 12 ], the paracortical areas of lymph nodes contain at least three subsets of dendritic cells with different immunophenotypes: interdigitated dendritic cells (S-100 positive, CD1a sparsely positive, langerin negative), Langerhans cells (S-100 positive, CD1a positive, langerin positive), and few dendritic cells (S-100 positive, CD1a negative, langerin negative). (3) Infectious mononucleosis is an EBV infection-induced proliferative lesion of the lymph nodes and tonsils that is commonly observed in adolescents and young adults and has a short disease course.…”

Section: Discussionmentioning

confidence: 99%

Adult-onset Still’s disease with multiple lymphadenopathy: a case report and literature review

Huang

Min

et al. 2021

Diagn Pathol

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Background Adult-onset Still’s disease (AOSD) often presents with systemic multiple lymphadenopathy. In addition to the common paracortical and mixed patterns in AOSD lymph node histopathological features, other morphological patterns include diffuse, necrotic, and follicular patterns. However, to date, there have been few reports on the histopathological description of AOSD lymph nodes. Case presentation An 18-year-old woman presented 2 months earlier with pain in her large joints with painless rash formation; bilateral posterior cervical lymph node, left supraclavicular lymph node, and left posterior axillary lymph node enlargement, and no tenderness. Left cervical lymph node resection was performed for pathological examination. The lymph node structure was basically preserved, and subcapsular and medullary sinus structures were observed. Many histiocytes in the sinus were observed, the cortical area was reduced, a few lymphoid follicles of different sizes were observed, and some atrophy and hyperplasia were noted. The lymphoid tissue in the paracortical region of the lymph node was diffusely proliferative and enlarged, mainly comprising histiocytes with abundant cytoplasm, immunoblasts and numerous lymphocytes with slightly irregular, small- to medium-sized nuclei. Nuclear karyorrhexis was easily observed, showing a few nuclear debris and the “starry sky” phenomenon, accompanied by abundantly branching high endothelial small vessels with few scattered plasma cells and eosinophil infiltration. Lymphoid follicle immunophenotype with reactive proliferative changes was observed. Approximately 40% of the cells in the paracortical region were positive for Ki-67, and the histiocytes expressed CD68, CD163, and some expressed S-100, with the absence of myeloperoxidase. The immunoblasts expressed CD30 and CD20, not ALK or CD15. Background small- to medium-sized T cells expressed CD2, CD3, CD5, CD7, CD4, and CD8; the number of CD8-positive T cells was slightly predominant, and a small number of T cells expressed granzyme B and T-cell intracellular antigen 1. The patient received a comprehensive medical treatment after the operation, and her condition was stable without progression at the 11-month follow-up evaluation. Conclusions The pathological features of AOSD lymphadenopathy raises the awareness of AOSD among pathologists and clinicians and aids in the diagnosis and differential diagnosis of AOSD lymphadenopathy from other reactive lymphadenopathies (lupus lymphadenitis, etc.) and lymphomas.

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Section: Discussionmentioning

confidence: 99%

Adult-onset Still’s disease with multiple lymphadenopathy: a case report and literature review

Huang

Min

et al. 2021

Diagn Pathol

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“…Histomorphology often shows a pale nodular appearance in the paracortical region, which is mainly composed of proliferating interdigitated dendritic cells, Langerhans cells, and pigment laden histiocytes. Some studies have shown that in dermatopathic lymphadenopathy lesions [11], the paracortical areas of lymph nodes contain at least three subsets of dendritic cells with different immunophenotypes: interdigitated dendritic cells (S100 positive, CD1a sparsely positive, langerin negative), Langerhans cells (S100 positive, CD1a positive, langerin positive) and few dendritic cells (S100 positive, CD1a negative, langerin negative). 3 Infectious mononucleosis(IM):IM is an EBV infection induced proliferative lesion of lymph nodes and tonsils, commonly seen in adolescents and young adults, has a short disease course, and histologic features vary with disease duration.…”

Section: Discussionmentioning

confidence: 99%

Adult Onset Still's Disease With Multiple Lymphadenopathy: a Case Report and Literature Review

Huang

Min

et al. 2021

Preprint

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Background: Adult onset Still's disease (AOSD) is a rare systemic autoinflammatory disorder that often presents with systemic multiple lymphadenopathy. In addition to the common paracortical and mixed patterns in AOSD lymph nodes histopathological features, the other morphological patterns include diffuse, necrotic, and follicular patterns. However, there have been very few reports to date on the histopathological description of AOSD lymph nodes.Case presentation: An 18-year-old female presented two months earlier with pain in her large joints with painless rash formation, bilateral posterior cervical lymph nodes, left supraclavicular lymph nodes and left posterior axillary lymph nodes enlargement, and no tenderness. Left cervical lymph node resection was performed for pathological examination. Histologically, lymph node structure is basically preserved, subcapsular sinus, medullary sinus structure exists, there is a lot of histiocytes in the sinus, cortical area is reduced, a few lymphoid follicles of different sizes can be seen, some atrophy, some hyperplasia. The lymphoid tissue in the paracortical region of the lymph node was diffusely proliferative and enlarged, mainly composed of histiocytes with abundant cytoplasm, immunoblasts, and numerous lymphocytes with slightly irregular small to medium-sized nuclei. Nuclear karyorrhexis was easily observed, showing a few nuclear debris and the “starry sky” phenomenon, accompanied by abundant branching high endothelial small vessels with a background of scattered few plasma cells and eosinophil infiltration. Immunohistochemically, lymphoid follicle immunophenotype with reactive proliferative changes. About 40% of the cells in the paracortical region were positive for Ki-67, and the histiocytes expressed CD68, CD163, some expressed S-100, and no MPO. The immunoblasts expressed CD30, CD20, and not ALK or CD15. Background small to medium-sized T cells express CD2, CD3, CD5, CD7, CD4, and CD8, the number of CD8 positive T cells is slightly predominant, and a small number of T cells express GRB and TIA-1. The patient received comprehensive medical treatment after operation, and the condition was stable without progression at the 11-month follow-up evaluation.Conclusion: The presentation of morphologic cases of AOSD lymphadenopathy will increase the awareness of AOSD among pathologists and clinicians, and aid in the diagnosis and differential diagnosis of AOSD lymphadenopathy from other reactive lymphadenopathies and lymphomas.

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“…In DL, axillary and inguinal nodes are most commonly affected, but other lymph node groups have also been reported, for example, intramammary node as in this case. [4] The intramammary node appearance as a markedly FDG-avid breast nodule in 18 F-FDG PET/CT was of concern to the clinician in that biopsy was performed for exclusion of breast malignancy. Garces et al reported a cohort of 42 patients with DL, where axillary and ipsilateral intramammary node involvement was detected in 7% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Garces et al reported a cohort of 42 patients with DL, where axillary and ipsilateral intramammary node involvement was detected in 7% of cases. [4] This should be taken into consideration with suspected DL to avoid invasive investigation with potential harm to the patient.…”

Section: Discussionmentioning

confidence: 99%

A case of dermatopathic lymphadenitis mimicking lymphoma on 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging

Hui

Kung

et al. 2021

World J Nucl Med

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Clinical, histopathologic, and immunoarchitectural features of dermatopathic lymphadenopathy: an update

Cited by 21 publications

References 50 publications

Adult-onset Still’s disease with multiple lymphadenopathy: a case report and literature review

Adult-onset Still’s disease with multiple lymphadenopathy: a case report and literature review

Adult Onset Still's Disease With Multiple Lymphadenopathy: a Case Report and Literature Review

A case of dermatopathic lymphadenitis mimicking lymphoma on 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging

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