Cite this page: Balakrishna J, Sharabi A. Other pigment / foreign material. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodesotherpigment.html. Accessed January 26th, 2023.
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
- 26 year old man with mesothelioma due to asbestos exposure (Case Rep Med 2011;2011:951732)
Clinical images
Images hosted on other servers:
Asbestos with mesothelioma:
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
- Gold deposits can mimic intranodal axillary calcific deposits on mammography in patients with rheumatoid arthritis (Proc (Bayl Univ Med Cent) 2013;26:28)
Case reports
- 34 year old woman with lymphadenopathy and lymph node infarction (J Clin Pathol 2001;54:562)
- Intramammary lymph node gold deposits simulating microcalcifications on mammogram (Hum Pathol 1988;19:992)
- Lymphadenopathy and lymph node infarction (Am J Med 1986;80:537)
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
Images hosted on other servers:
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
- 27 year old woman with prior giant cell tumor (Acta Cytol 2002;46:772)
Microscopic (histologic) description
- Giant cells (mono or multinuclear) with foamy and vacuolated cytoplasm