Lymph nodes & spleen, nonlymphoma
Lymph nodes-inflammatory / reactive disorders
Allergic granulomatosis
Topic Completed: 1 January 2016
Minor changes: 6 April 2020
Revised: 4 February 2019, last major update January 2016
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PubMed Search: Allergic granulomatosis[TI]
Table of Contents
Definition / general | Essential features | Terminology | Pathophysiology | Clinical features | Diagnosis | Laboratory | Radiology description | Prognostic factors | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosis | Additional referencesCite this page: Balakrishna J. Allergic granulomatosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodesallergicgranulomatosis.html. Accessed April 15th, 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
Terminology
- Noninfectious necrotizing granulomatosis
Pathophysiology
- Allergic reaction
Clinical features
- Lymphadenopathy
- Asthma and allergic sinusitis
Diagnosis
- Microscopy
Laboratory
- Nonspecific
- Elevated IgE
- Eosinophilia
Radiology description
- Lymphadenopathy
Prognostic factors
- Good response to steroid therapy
Case reports
- 11 year old boy with lymph node manifestations of limited Churg-Strauss syndrome (J Pediatr Hematol Oncol 2000;22:468)
- 56 year old man with allergic granulomatosis secondary to a limited form of Churg-Strauss syndrome (Arch Pathol Lab Med 2001;125:954)
Treatment
- 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
Images hosted on other servers:
Eosinophilic vasculitis
Lymph node architecture
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
