Lymph nodes - not lymphoma
Infectious / parasitic disorders
Whipple disease

Topic Completed: 1 June 2006

Revised: 4 February 2019, last major update June 2006

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

PubMed Search: Whipple disease lymph nodes

Page views in 2018: 743
Page views in 2019 to date: 750
Cite this page: DePond W. Whipple disease. website. Accessed October 22nd, 2019.
Definition / general
  • Rare; due to infection by Tropheryma whipplei, present in soil and sewage but not animals
  • Typically affects farmers and outdoor workers
  • Symptoms include diarrhea, malabsorption, weight loss, fever, arthralgias; also occasional CNS and cardiac involvement
  • May cause marked enlargement of mesenteric and periaortic lymph nodes; enlargement of peripheral lymph nodes may occur early
  • Diagnosis requires massive involvement of node plus intense PAS+ staining (small aggregates of PAS+ macrophages are nonspecific) or PCR
  • Gram stain: gram+ bacteria
Case reports
  • IV penicillin and streptomycin or third generalization cephalosporin for 10 - 14 days, plus cotrimoxazone for 1 year
Microscopic (histologic) description
  • Nodal architecture obscured by ill defined lipogranulomas
  • Involvement of sinuses by macrophages with foamy cytoplasm
Microscopic (histologic) images

Images hosted on PathOut server:

Contributed by Dr. Mark R. Wick:

Various images

PAS stain

Warthin-Starry stain

Images hosted on other servers:

Nodal biopsies (figs 3 and 4)

Abdominal node (fig 2)

Positive stains
Negative stains
Electron microscopy description
  • Rod-like organisms
Electron microscopy images

Images hosted on other servers:

Trilaminar cell wall

Molecular / cytogenetics description
Differential diagnosis
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