Lymph nodes & spleen, nonlymphoid
Lymph nodes-infectious / parasitic disorders
Whipple disease


Topic Completed: 1 June 2006

Minor changes: 21 July 2020

Revised: 4 February 2019, last major update June 2006

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

PubMed Search: Whipple disease lymph nodes


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Cite this page: DePond W. Whipple disease. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphnodeswhipple.html. Accessed August 7th, 2020.
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
Treatment
  • 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

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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