Lymph nodes & spleen, nonlymphoma
Pigment / foreign material
Other pigment / foreign material


Topic Completed: 1 February 2014

Minor changes: 6 April 2021

Copyright: 2003-2021, PathologyOutlines.com, Inc.

PubMed Search: Asbestos [title] lymph nodes, Gold deposits [title] lymph nodes, Lipogranuloma[TI], Prosthesis related changes lymph nodes

Jayalakshmi Balakrishna, M.D.
Abdelsalam Sharabi, M.D.
Page views in 2021 to date: 21
Cite this page: Balakrishna J, Sharabi A. Other pigment / foreign material. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodesotherpigment.html. Accessed April 18th, 2021.
Asbestos

Terminology
  • Also called Ferruginous bodies

Epidemiology
  • Usually due to industrial / occupational exposure

Sites
  • Most common in thoracic / hilar lymph nodes
  • Concentration of asbestos fibers in lymph nodes is 2 - 3x higher than in lung

Clinical features
  • Inhaled asbestos fibers have iron protein mucopolysaccharide coating
  • Enlarged lymph nodes are common
  • Associated symptoms / signs of pulmonary asbestosis

Diagnosis
  • Biopsy of affected lymph node
  • Bleach digestion for confirmation

Radiology description
  • Mediastinal / hilar lymphadenopathy

Prognostic factors
  • Pulmonary asbestosis is a risk factor for lung carcinoma and mesothelioma

Case reports

Clinical images

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Asbestos with mesothelioma:

Enlarged supraclavicular node

Epiphrenic node on right

Node inside lesion



Gross description
  • Lymph nodes may be enlarged but show no significant abnormalities on cut surface

Microscopic (histologic) description
  • Asbestos bodies are golden-brown, beaded or dumbbell shaped structures with a thin, translucent core

Differential diagnosis
  • Pseudoasbestos bodies
  • Other ferruginous bodies

Additional references
Gold

Definition / general
  • Colloidal gold is used for anti-tumor therapy, to treat autoimmune diseases and for drug delivery (Wikipedia: Colloidal gold [Accessed 22 June 2018])
  • Lymphadenopathy and lymph node infarction are uncommon complications of gold injections; occur via accumulation of gold particles in macrophages

Sites
  • Cervical, axillary, mesenteric lymph nodes, depending on route of administration

Clinical features
  • Tender enlarged lymph nodes
  • Benign process with resolution of symptoms on withdrawal of gold treatment

Diagnosis
  • Biopsy
  • Darkfield microscopy and autometallography methods demonstrate gold nanoparticles 15 to 50 nm

Laboratory
  • Polymorphonuclear neutrophilia, leukopenia, thrombocytopenia
  • Hepatic toxicity

Radiology description

Case reports

Gross description
  • Extensive necrosis of lymph node

Microscopic (histologic) description
  • Subtotal or complete infarction with peripheral rim of organizing granulation tissue in region of subcapsular sinus
  • Small focus of residual viable lymphoid tissue has features of follicular hyperplasia
  • Center of node has ghost outlines of necrotic cells

Microscopic (histologic) images

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Missing Image

Infarcted tissue

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Reticulin: preservation of nodal architecture



Positive stains
  • Immunohistochemical stains confirm the reactive nature of the process

Differential diagnosis
  • Lymphoma
  • Vascular thrombosis, infections and mechanical pressure can also cause infarction of lymph nodes

Additional references
Lipogranuloma

Definition / general
  • Also called lipophagic granuloma
  • Secondary to various inflammatory and neoplastic conditions or primary lesion of lymph node
  • In West, commonly due to mineral oil ingestion or total parenteral nutrition

Case reports

Microscopic (histologic) description
  • Giant cells (mono or multinuclear) with foamy and vacuolated cytoplasm
Prosthesis related

Definition / general

Case reports

Microscopic (histologic) description
  • Sinuses distended by large macrophages with abundant granular PAS+ eosinophilic cytoplasm representing polyethylene (Am J Surg Pathol 1989;13:1050)
  • May contain black specks which resemble "dirt"
  • Pelvic lymph nodes in patients with cobalt chromium or titanium hip implants may have heavy metal microparticles or polyethylene particles with associated florid sinus histiocytosis (Am J Surg Pathol 1994;18:83)

Microscopic (histologic) images

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Sinus histiocytosis



Positive stains
  • PAS+ polyethylene particles

Electron microscopy images

Images hosted on other servers:
Missing Image

Particles are 1 micron



Differential diagnosis
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