Lymph nodes - not lymphoma
Inflammatory disorders (noninfectious)

Topic Completed: 1 November 2016

Revised: 4 February 2019, last major update November 2016

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Amyloid[TI] lymph node

Jayalakshmi Balakrishna, M.D.
Page views in 2018: 1,233
Page views in 2019 to date: 1,110
Cite this page: Balakrishna J. Amyloid. website. Accessed September 18th, 2019.
Definition / general
  • Uncommon disease caused by the deposition of abnormal proteins within the soft tissues
Essential features
  • Extracellular deposition of amorphous, eosinophilic, hyaline substance
  • Amyloid is Congo red+
  • Amyloid, amyloidosis, amyloid lymphadenopathy
  • Rare
  • Cervical, supraclavicular and mediastinal lymph nodes
  • Any lymph node group can be affected
  • Results from abnormal folding of proteins
  • Proteins that form amyloid can be (a) normal proteins that have an inherent tendency to fold improperly, associate and form fibrils and do so when they are produced in increased amounts and (b) mutant proteins that are prone to misfolding and subsequent aggregation
  • As part of primary systemic amyloidosis
  • As part of reactive systemic amyloidosis
  • In uremic patients
  • In non-Hodgkin lymphoma
  • As isolated primary deposits in lymph nodes
Clinical features
  • Lymph node enlargement
  • In secondary cases, depending on the primary condition
  • Histologic demonstration of amyloid
  • If associated with monoclonal proteins of B cell lymphoma, serum and urine protein electrophoresis will demonstrate monoclonal proteins
Radiology description
  • None specific
  • Enlarged lymph nodes
Prognostic factors
  • Generalized amyloidosis tends to have poor prognosis
Case reports
  • Treatment of the associated condition
  • Treatments inhibiting protein misfolding and fibrillogenesis are under study
Gross description
  • Enlarged lymph node with firm waxy cut surfaces
Gross images

Images hosted on PathOut server:

Contributed by Dr. Mark R. Wick:
Microscopic (histologic) description
  • Hyaline-like amorphous eosinophilic depositions positive for Congo red staining
  • Polarizing microscope shows unique yellowish green birefringence
Microscopic (histologic) images

Images hosted on PathOut server:

AFIP images:

Amyloidosis of lymph node

Contributed by Dr. Mark R. Wick:

Images hosted on other servers:


Various images

Acellular, amorphous, eosinophilic amyloid deposits

Polarized light

Cytology description
  • Hyaline-like amorphous material on cytology smears
  • Acellular and associated with connective tissue
  • Eosinophilic to blue / green with Pap stain, deep blue with Diff-Quik
Positive stains
Negative stains
Electron microscopy description
  • Clusters of round / oval nodules, often enclosed with cytoplasmic processes of macrophages or reticulum cells
  • Fibrils are nonbranching, 7.5 nm in diameter, form parallel bundles close to cytoplasmic membranes
Differential diagnosis
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