Lymph nodes - not lymphoma
Inflammatory disorders (noninfectious)
Follicular hyperplasia

Topic Completed: 1 June 2006

Revised: 4 February 2019, last major update June 2006

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

PubMed Search: Follicular hyperplasia[TI] lymph node

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Cite this page: DePond W. Follicular hyperplasia. website. Accessed October 22nd, 2019.
Definition / general
Diagrams / tables

Images hosted on other servers:

Various patterns

Gross description
  • Usually less than 1 cm
  • Pink homogenous cut surface
  • May resemble fat
Microscopic (histologic) description
  • Nodal architecture is preserved
  • Usually no / minor infiltration of capsule and perinodal adipose tissue
  • Follicles are markedly variable in size and shape
  • Margins are sharply defined and surrounded by a mantle layer of IgD+ small lymphocytes, often with an onion skin pattern and sometimes primarily on one pole of the follicle
  • Follicles are composed of centrocytes (small) and centroblasts (large)
  • Interfollicular lymphocytes differ from follicular lymphocytes
  • Tingible body macrophages (with nuclear debris) and mitotic figures are common
  • Large number of dendritic cells with intact dendritic meshwork by CD21 / CD35 staining
Microscopic (histologic) images

Images hosted on PathOut server:

Contributed by Dr. Mark R. Wick:

Cortical and paracortical hyperplasia

AFIP images:

Reactive follicular hyperplasia

lymphoid follicle
contrasted with
neoplastic follicles

Cellular composition of hyperplastic follicle

Hyperplastic follicle
contrasted with
neoplastic follicle

Immunostaining BCL2 protein

Reactive follicular hyperplasia contrasted with follicular lymphoma

Reactive follicular
hyperplasia with
monocytoid B cell

Florid reactive follicular hyperplasia with deficient mantles

AIDS related
with florid follicular

Nonspecific paracortical hyperplasia

Plasmacytoid monocytes in in reactive lymph node

Follicular hyperplasia with follicle lysis in HIV infection

Images hosted on other servers:

Various images

Tingible body macrophages

Cytology description
  • Tingible body macrophages, no lymphoid aggregates, no two nuclei-like cleaved cells, no / rare prominent nucleoli (Diagn Cytopathol 2006;34:11)
Negative stains
Molecular / cytogenetics description
  • Usually no clonality but rarely is clonal by flow cytometry and molecular methods with no clinical evidence of lymphoma - these cases occurred in normal young males and an HIV+ young woman (Am J Clin Pathol 2004;121:464)
Differential diagnosis
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