Approach at lymph node pathology and ancillary techniques

106 Pages·2012·29.82 MB·English

Approach at lymph node pathology and
ancillary techniques
Hans Konrad Müller-Hermelink
Institute of Pathology, University of Würzburg
Würzburg, Germany
1000 km
400 km
Würzburg
Germany: 80.000.000 population Würzburg: 200.000 population

….contemporary lymphoma diagnosis integrates histology,
immunophenotype, (molecular) genetic data as well as clinical features …

Frequency of lymph node diseases in
primary material
Lymphadenitis 6141 56%
Metastasis 2658 24%
Lymphoma 1636 15%

B-cell line: 65%
T-cell line: 8%
Hodgkin: 27%
Granulomatous lymphadenitis 357 3%
Other infectious types of
lymphadenitis 230 2%
Autoimmune disease 28 <1%
Reactive Hyperplasias and Reaction
Patterns in different compartments
Sinus reactions
B-cell compartment
• Sinus histiocytosis
• Follicular hyperplasia
• Foreign body reaction
• Sinusoidal B-cell reaction
• Mastozytosis
• Marginal zone reaction/ nodules
• Sinus lymphocytosis
• Extrafollicular B-cell activation
Macrophage reactions
• Plasmacytosis
• Foreign body reactions
• Progressive transformation of
• Epitheloid cell reactions
germinal centres
• Purulent granulomas
T-cell compartment
• Nodular paracortical hyperplasia
• Diffuse paracortical hyperplasia
– CD 4 dominant DTH activation
– CD 8 dominant cytotoxic
activation