Infectious / inflammatory disorders
Follicular hyperplasia

Author: Jaleh Mansouri, M.D. (see Authors page)

Revised: 1 March 2018, last major update October 2012

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

PubMed Search: Follicular hyperplasia spleen[TIAB]

Cite this page: Mansouri, J. Follicular hyperplasia. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/spleenfollicularhyperplasia.html. Accessed March 23rd, 2018.
Definition / general
  • Also called reactive follicular hyperplasia
  • Focal or diffuse
  • Normal in children
  • In adults, due to systemic infection (malaria, measles, typhoid fever, virus, other), immune mediate disorders (hemolytic anemia, immune thrombocytopenic purpura, rheumatoid arthritis)
  • Often associated with congestion and plasmacytic proliferation
  • Associated with hypersplenism in Zaire, Nigeria and New Guinea, where spleens also show extramedullary hematopoiesis and marked sinusoidal dilation; may be related to malaria
  • Note: graft rejection and AIDS are associated with reactive nonfollicular hyperplasia, which may resemble lymphoma but has heterogeneous lymphocytic population without atypia and without clonality
  • Felty syndrome (rheumatoid arthritis): no granulocytic phagocytosis but expansion of red pulp cords and sinuses with macrophages
Gross description
  • May have enlarged spleen with multiple small, pale tan nodules or solitary large nodules resembling lymphoma (Am J Surg Pathol 1983;7:373)
Microscopic (histologic) description
  • Resemble nodal reactive follicles, with mixed follicular center population and tingible body macrophages
  • Usually mature lymphocytes and plasma cells in red pulp