Lymph nodes & spleen, nonlymphoma
Lymph node-nonspecific findings
Chronic lymphadenitis
Author: Jayalakshmi Balakrishna, M.D.
Last author update: 1 February 2016
Last staff update: 20 December 2023 (update in progress)
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Chronic lymphadenitis[TIAB]
Table of Contents
Definition / general | Essential features | Terminology | Sites | Clinical features | Diagnosis | Laboratory | Prognostic factors | Clinical images | Gross description | Microscopic (histologic) description | Cytology description | Positive stains | Negative stains | Flow cytometry description | Differential diagnosis | Additional referencesCite this page: Balakrishna J. Chronic lymphadenitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodeschroniclymphadenitis.html. Accessed April 25th, 2024.
Definition / general
- Common, chronic inflammatory process of lymph nodes in response to various pathogens
- May be specific or nonspecific, known or unknown
- Lymph nodes show variable amounts of necrosis, abscesses, granulomas and fibrosis
Essential features
- Nonspecific etiology
- General histological features are follicular hyperplasia, prominence of postcapillary venules, increased number of immunoblasts, plasma cells, histiocytes and fibrosis
Terminology
- Also called chronic nonspecific lymphadenitis
Sites
- Cervical or any other lymph node groups can be affected
Clinical features
- Enlarged lymph nodes (by palpation or imaging)
- Painless
Diagnosis
- Biopsy and clinical history are necessary
- Adjuvant diagnostic methods such as special stains, electron microscopy, immunohistochemistry, in situ hybridization analysis and polymerase chain reaction (PCR) techniques help delineate specific causative factors
Laboratory
- Specific findings depend on the etiology
Prognostic factors
- Good prognosis in general, although prognosis and treatment vary based on specific etiology
Clinical images
Images hosted on other servers:
Lymphadenopathy
Gross description
- Enlarged lymph node
- Capsule may be thickened
Microscopic (histologic) description
- Follicular hyperplasia, prominence of postcapillary venules, increased number of immunoblasts, plasma cells and histiocytes and fibrosis
- Capsule may be inflamed or fibrotic
- Inflammation / fibrosis may extend into the immediate perinodal tissues
- Terms such as xanthogranulomatous lymphadenitis and eosinophilic lymphadenitis are used to describe cases with undue prominence of eosinophils, foamy macrophages or mast cells
Cytology description
- Smear derived from reactive follicle: centroblasts, centrocytes, small lymphocytes and tingible body macrophages with nuclear fragments
- Paracortical hyperplasia: spectrum of basophilic cells, ranging from mature plasma cells to immunoblasts with a background of many small lymphocytes
Positive stains
- T cell and B cell markers show reactive pattern
Negative stains
- Special stains for microorganisms
- Immunohistochemical stains / patterns for lymphoma
Flow cytometry description
- Reactive pattern: mixed / polyclonal population
Differential diagnosis
- Malignant: lymphoma, metastases
- Specific infections: atypical mycobacteria, fungal infections, leprosy, parasites, syphilis, tuberculosis
- Specific inflammatory lesions: Castleman disease, dermatopathic lymphadenitis, lupus erythematosus, rheumatoid arthritis, sarcoidosis
