Lymphoid follicular pattern: a normal feature of the pediatric colon

Isolated Lymphoid Follicles are Dynamic Reservoirs for the Induction of Intestinal IgA

“…In children, a common endoscopic finding is the large number of tiny lymphoid nodules located in the terminal ileum and colon referred to as lymphonodular hyperplasia (LNH), or nodular lymphoid hyperplasia (Laufer and deSa, 1978). It was first described as an age-related finding in children of minimal significance, but further work noted a close association between LNH and the development of food allergies.…”

Crohn's Disease Associated with Diffuse Lymphoid Hyperplasia of the Large Intestine. A Possible Role of the Lymph Follicle in HLA-DR Antigen Expression on Epithelium.

“…Diseases associated with lymphoid hyperplasia include milk allergy (9), bacterial and viral infection (9, 18, 19), Crohn's disease (12, 13, 15, 16), ulcerative colitis (15, 16), colorectal cancer (16, 17), sarcoidosis (19), and immunoglobulin deficiency (20). In these instances, the lymphoid nodules tend to be greater than 2mm in diameter in childhood (12) and greater than 4mm in adults (13,16). In sarcoidosis, noncaseating granulomatous inflammation, consistent with sarcoidosis , has been demonstrated in biopsy specimens from the lymphoid nodules (19).…”

Spectrum of lymphoid hyperplasia: Colonic manifestations of sarcoidosis, infectious mononucleosis, and Crohn's disease

“…In this instance, it probably represents a nonspecific immune response to the disease rather than direct involvement. Morson [23] and Laufer and de Sa [9] suggested but never proved that such might be the case. In the absence of a previously unremarkable colon examination, this pattern could not be distinguished from the normal variant, which may co-exist with Crohn's disease.…”

“…In the first place, the term nodular tymphoidhyperplasia is probably misleading, since the majority of cases represent normal variants. At least for these latter cases, a more neutral term such as the lymphoid follicular pattern, as proposed by Laufer and de Sa [9], seems more appropriate. Laufer and de Sa would reserve the older term for cases in which the submucosal nodules are greater than 2 mm in diameter or irregularly distributed.…”

“…For unclear reasons, the colonic aggregates of lymphoid tissue may or may not be visible on endoscopic or radiologic examination. Although originally felt to signify some pathologic process and to require therapy [2][3][4][5][6][7], the pattern of lymphoid hyperplasia of the colon -in which are ibund multiple, uniformly distributed, submucosal nodules of less than 4 mm in diameteris now felt to represent a normal feature of childhood and a normal variant in adulthood [8][9][10][11]. Kelvin and colleagues [10] found this pattern in 13% of their patient series, and demonstrated no correlation with any particular defect or with disease in general.…”