Lymph nodes & spleen, nonlymphoid
Lymph nodes-inclusions, pigment, ectopic cells or tissue

Topic Completed: 1 April 2014

Minor changes: 20 July 2020

Revised: 1 February 2019, last major update April 2014

Copyright: 2003-2020,, Inc.

PubMed Search: Iron [title] lymph nodes

Jayalakshmi Balakrishna, M.D.
Abdelsalam Sharabi, M.D.
Page views in 2019: 773
Page views in 2020 to date: 364
Cite this page: Balakrishna J. Iron. website. Accessed August 6th, 2020.
Definition / general
  • Iron deposition in lymph nodes is rare
  • Also called hemosiderosis
  • May be associated with hemochromatosis
  • Portal, splenic, mesenteric or axillary, depending on the primary cause
  • Parenteral iron administration
  • Multiple transfusions: red blood cells are lysed and iron is deposited in macrophages in the liver and spleen followed by drainage to adjacent lymph nodes
  • Hereditary hemosiderosis: abnormalities in iron transport - most common is HFE1 gene mutation; also mutations in TfR2, HJV, HAMP, ferroportin-V162del (Hepatology 2005;42:466)
  • Anemia of inflammation: associated with rheumatoid arthritis (Ann Rheum Dis 1970;29:81), gout
Clinical features
  • Depends on the primary cause
  • Enlarged lymph nodes
  • Biopsy with Perls Prussian blue stain
Radiology description
Radiology images

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Various images

Prognostic factors
  • Depends on the primary cause, severity and extent of the disease
Case reports
  • Reduce iron overload, treat the primary cause
Gross description
  • Enlarged lymph nodes
Gross images

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Lymph nodes at bottom right

Microscopic (histologic) description
  • Follicular hyperplasia, sinus histiocytosis, golden brown pigment deposition
Molecular / cytogenetics images

Contributed by Dr. Mark R. Wick

In sickle cell disease

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Hyperplasia of histiocytes and increased plasma cells

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Perls iron stain shows staining of histiocytes in sinuses


Positive stains
Negative stains
Electron microscopy description
  • Prominent phagocytic reticulum cells containing vacuoles, myelin figures, lipid droplets and very large lysosomal bodies with fine electron dense granules concentrated in these lysosomal bodies and in the cytoplasm, which show molecular structure of ferritin
Differential diagnosis
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