Lymph nodes & spleen, nonlymphoma

Lymph nodes-inflammatory / reactive disorders

Allergic granulomatosis

Topic Completed: 1 January 2016

Minor changes: 13 October 2021

Copyright: 2003-2021,, Inc.

PubMed Search: Allergic granulomatosis[TI]

Jayalakshmi Balakrishna, M.D.
Page views in 2020: 605
Page views in 2021 to date: 592
Cite this page: Balakrishna J. Allergic granulomatosis. website. Accessed October 23rd, 2021.
Definition / general
  • Allergic granulomatosis is a rare disorder of obscure etiology characterized by infiltration of lymph nodes with histiocytic granulomas and eosinophils
  • Due to isolated lymph node involvement by Churg-Strauss syndrome; also lymph node involvement by polyarteritis nodosa, granulomatosis with polyangiitis (Wegener's) or lupus erythematous
Essential features
  • Necrotizing granulomas
  • Eosinophils
  • Immunohistochemistry typical of reactive lymph node
  • Special stains for microorganisms negative
  • Noninfectious necrotizing granulomatosis
  • Allergic reaction
Clinical features
  • Lymphadenopathy
  • Asthma and allergic sinusitis
  • Microscopy
  • Nonspecific
  • Elevated IgE
  • Eosinophilia
Radiology description
  • Lymphadenopathy
Prognostic factors
  • Good response to steroid therapy
Case reports
  • Steroids
Gross description
  • Enlarged lymph node
Microscopic (histologic) description
  • Conspicuous necrosis with eosinophilia and vasculitis
  • Vasculitis
  • Vessels may show sclerotic thickening
  • Epithelioid granulomas
  • Florid follicular hyperplasia
Microscopic (histologic) images

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Eosinophilic vasculitis

Positive stains
  • Preserved B cell as well as T cell areas typical of a reactive lymph node
Negative stains
  • Special stains / immunostains for microorganisms
Differential diagnosis
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