Lymph nodes & spleen, nonlymphoid
Lymph nodes-inflammatory disorders
Rheumatoid arthritis


Topic Completed: 1 June 2006

Minor changes: 14 August 2020

Copyright: 2003-2020, PathologyOutlines.com, Inc.

PubMed Search: Rheumatoid arthritis[TI] lymph nodes

See also: Hyaline deposits, Gold deposits

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Cite this page: DePond W. Rheumatoid arthritis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphnodesrheumatoidarthritis.html. Accessed October 29th, 2020.
Definition / general
  • Associated with lymphadenopathy during course of disease in 82%, usually axillary (J Int Med Res 2003;31:345)
  • Lymphadenopathy usually disappears during disease remission
  • May also have fever, weight loss, anemia
  • Modestly increased risk of lymphoma, may be due to methotrexate treatment
Microscopic (histologic) description
  • Follicular hyperplasia with sparse (J Clin Pathol 1990;43:106) vs. active (Acta Pathol Jpn 1990;40:249) proliferative activity, interfollicular plasma cells with Russell bodies, vascular proliferation
  • Capsular lymphocytic infiltrate
  • May resemble plasma cell variant of Castleman disease
  • Often PAS+ extracellular hyaline material
  • Occasionally focal necrosis and microabscesses
  • May have sarcoid-like granulomas
Microscopic (histologic) images

AFIP images

Reactive lymphadenopathy of rheumatoid arthritis



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Follicular hyperplasia
with eosinophilic
material in
interfollicular areas

Extensive replacement
by focally calcified
eosinophilic material

Rounded, well
separated follicles
with expanded
paracortex

Follicular center composed
primarily of centrocytes,
with no / rare tingible body
macrophages or mitotic figures

Interdigitating dendritic
cells (CD1+) are associated
with small lymphocytes

Negative stains
  • Polyclonal plasma cells (no light chain restriction)
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