Lymph nodes - not lymphoma
Inclusions, pigment, ectopic cells or tissue
Iron

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

Revised: 25 June 2018, last major update April 2014

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

PubMed Search: Iron [title] lymph nodes

Cite this page: Balakrishna, J. Iron. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphnodesiron.html. Accessed July 21st, 2018.
Definition / general
  • Iron deposition in lymph nodes is rare
  • Also called hemosiderosis
  • May be associated with hemochromatosis
Sites
  • Portal, splenic, mesenteric or axillary, depending on the primary cause
Pathophysiology
  • Parenteral iron administration
  • Multiple transfusions: red blood cells are lysed and iron is deposited in macrophages in the liver and spleen followed by drainage to adjacent lymph nodes
  • Hereditary hemosiderosis: abnormalities in iron transport - most common is HFE1 gene mutation; also mutations in TfR2, HJV, HAMP, ferroportin-V162del (Hepatology 2005;42:466)
  • Anemia of inflammation: associated with rheumatoid arthritis (Ann Rheum Dis 1970;29:81), gout
Clinical features
  • Depends on the primary cause
  • Enlarged lymph nodes
Diagnosis
  • Biopsy with Perls Prussian blue stain
Radiology description
Radiology images

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Various images

Prognostic factors
  • Depends on the primary cause, severity and extent of the disease
Case reports
Treatment
  • Reduce iron overload, treat the primary cause
Gross description
  • Enlarged lymph nodes
Gross images

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Lymph nodes at bottom right

Microscopic (histologic) description
  • Follicular hyperplasia, sinus histiocytosis, golden brown pigment deposition
Molecular / cytogenetics images

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In sickle cell disease - Contributed by Dr. Mark R. Wick



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Hyperplasia of histiocytes and increased plasma cells

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Perls iron stain shows staining of histiocytes in sinuses

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Various images

Positive stains
Negative stains
Electron microscopy description
  • Prominent phagocytic reticulum cells containing vacuoles, myelin figures, lipid droplets and very large lysosomal bodies with fine electron dense granules concentrated in these lysosomal bodies and in the cytoplasm, which show molecular structure of ferritin
Differential diagnosis