Lymph nodes - not lymphoma
Inclusions, pigment, ectopic cells or tissue
Iron
Revised: 1 February 2019, last major update April 2014
Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.
PubMed Search: Iron [title] lymph nodes
Inclusions, pigment, ectopic cells or tissue
Iron
Author: Jayalakshmi Balakrishna, M.D.
Senior Author: Abdelsalam Sharabi, M.D.
Topic Completed: 1 April 2014
Revised: 1 February 2019, last major update April 2014
Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.
PubMed Search: Iron [title] lymph nodes
Table of Contents
Definition / general | Sites | Pathophysiology | Clinical features | Diagnosis | Radiology description | Radiology images | Prognostic factors | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Molecular / cytogenetics images | Positive stains | Negative stains | Electron microscopy description | Differential diagnosis | Additional referencesCite this page: Balakrishna J. Iron. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodesiron.html. Accessed May 30th, 2020.
Definition / general
- Iron deposition in lymph nodes is rare
- Also called hemosiderosis
- May be associated with hemochromatosis
Sites
- Portal, splenic, mesenteric or axillary, depending on the primary cause
Pathophysiology
- 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
Diagnosis
- Biopsy with Perls Prussian blue stain
Radiology description
- CT: enlarged and hyperdense lymph nodes (AJR Am J Roentgenol 1981;136:1191)
Radiology images
Images hosted on other servers:
Various images
Prognostic factors
- Depends on the primary cause, severity and extent of the disease
Case reports
- Women, 19 to 49 years, with lymphadenopathy after single infusion of iron dextran (J Clin Pathol 1968;21:492)
Treatment
- Reduce iron overload, treat the primary cause
Gross description
- Enlarged lymph nodes
Gross images
Images hosted on other servers:
Lymph nodes at bottom right
Microscopic (histologic) description
- Follicular hyperplasia, sinus histiocytosis, golden brown pigment deposition
Molecular / cytogenetics images
Images hosted on PathOut server:
In sickle cell disease - Contributed by Dr. Mark R. Wick
Images hosted on other servers:
Hyperplasia of histiocytes and increased plasma cells
Perls iron stain shows staining of histiocytes in sinuses
Various images
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
- Charcoal laden macrophages
- Hemazoin pigment: seen in malaria
- Melanin pigment deposition: melanoma, dermatopathic lymphadenitis
- Tattoo pigment
Additional references
