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
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
- 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:
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
- 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:
Infarcted tissue
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
- 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
Prosthesis related
Definition / general
- See also silicone
- May be an incidental finding at radical prostatectomy (J Clin Pathol 2002;55:623)
Case reports
- 76 year old woman with histiocytic lymphadenitis post shoulder joint replacement (Am J Clin Pathol 1993;99:314)
- 78 year old woman with right pelvic cystic mass due to chromium in hip prosthesis (Acta Cytol 2003;47:270)
- Post hip replacement with coexisting metastatic prostate adenocarcinoma to same lymph node (Hum Pathol 1998;29:95)
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
Images hosted on other servers:
Sinus histiocytosis
Positive stains
- PAS+ polyethylene particles
Electron microscopy images
Images hosted on other servers:
Particles are 1 micron
Differential diagnosis
