Lymph nodes - not lymphoma
Inflammatory disorders (non-infectious)
Chronic lymphadenitis

Author: Jaya Balakrishna, M.D. (see Authors page)
Editor: Abdelsalam Sharabi, M.D.

Revised: 13 February 2016, last major update February 2016

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Chronic lymphadenitis [title]
Cite this page: Chronic lymphadenitis. PathologyOutlines.com website. http://pathologyoutlines.com/topic/lymphnodeschroniclymphadenitis.html. Accessed August 21st, 2017.
Definition / general
  • Common, chronic inflammatory process of lymph nodes in response to various pathogens
  • May be specific or nonspecific, known or unknown
  • Lymph nodes show variable amounts of necrosis, abscesses, granulomas and fibrosis
Essential features
  • Non-specific etiology
  • General histological features are follicular hyperplasia, prominence of post capillary venules, increased number of immunoblasts, plasma cells, histiocytes and fibrosis
Terminology
  • Also called chronic non-specific lymphadenitis
Sites
  • Cervical or any other lymph node groups can be affected
Clinical features
  • Enlarged lymph nodes (by palpation or imaging)
  • Painless
Clinical images

Images hosted on Other servers:

Missing Image

Lymphadenopathy

Diagnosis
  • Biopsy and clinical history are necessary
  • Adjuvant diagnostic methods such as special stains, electron microscopy, immunohistochemistry, in situ hybridization analysis and polymerase chain reaction (PCR) techniques help delineate specific causative factors
Laboratory
  • Specific findings depend on the etiology
Prognostic factors
  • Good prognosis in general, although prognosis and treatment vary based on specific etiology
Gross description
  • Enlarged lymph node
  • Capsule may be thickened
Gross images

Images hosted on Other servers:

Missing Image

Due to tuberculosis

Microscopic (histologic) description
  • Follicular hyperplasia, prominence of post capillary venules, increased number of immunoblasts, plasma cells and histiocytes and fibrosis
  • Capsule may be inflamed or fibrotic
  • Inflammation / fibrosis may extend into the immediate perinodal tissues
  • Terms such as xanthogranulomatous lymphadenitis and eosinophilic lymphadenitis are used to describe cases with undue prominence of eosinophils, foamy macrophages or mast cells
Microscopic (histologic) images

Images hosted on Other servers:

Missing Image

Dermatopathic lymphadenopathy



Cat-Scratch Disease related:

Missing Image

Microabscesses

Missing Image

Stellate necrosis

Missing Image

Follicular hyperplasia

Missing Image

Warthin-Starry



Lymphogranuloma Venereum related:

Missing Image

Microabscesses

Missing Image

Necrotic focus with neutrophils



Syphilis related:

Missing Image

Hyperplasia, lymphoid follicles

Missing Image

Florid follicular hyperplasia

Missing Image

Chronic inflammation

Missing Image

Prominent vasculitis



Herpes Simplex Virus related:

Missing Image

Geographic necrosis

Missing Image

Cowdry Type A inclusions

Missing Image

Hematologic malignancies



Leprosy related:

Missing Image Missing Image Missing Image

Foamy histiocytes


Toxoplasmosis related:

Missing Image

Hyperplastic follicle

Missing Image

Clusters, epithelioid cells

Missing Image

Toxoplasma gondii


Cytology description
  • Smear derived from reactive follicle: centroblasts, centrocytes, small lymphocytes and tingible body macrophages with nuclear fragments
  • Paracortical hyperplasia: spectrum of basophilic cells, ranging from mature plasma cells to immunoblasts with a background of many small lymphocytes
Positive stains
  • T cell and B cell markers show reactive pattern
Negative stains
  • Special stains for microorganisms
  • Immunohistochemical stains / patterns for lymphoma
Flow cytometry description
  • Reactive pattern: mixed / polyclonal population
Differential diagnosis