Lymph nodes & spleen, nonlymphoma
Lymph nodes-infectious / parasitic disorders
Whipple disease

Topic Completed: 1 June 2006

Minor changes: 4 November 2020

Copyright: 2003-2021,, Inc.

PubMed Search: Whipple disease lymph nodes

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Cite this page: DePond WD. Whipple disease. website. Accessed January 17th, 2021.
Definition / general
  • Rare; due to infection by Tropheryma whipplei, present in soil and sewage but not animals
  • Typically affects farmers and outdoor workers
  • Symptoms include diarrhea, malabsorption, weight loss, fever, arthralgias; also occasional CNS and cardiac involvement
  • May cause marked enlargement of mesenteric and periaortic lymph nodes; enlargement of peripheral lymph nodes may occur early
  • Diagnosis requires massive involvement of node plus intense PAS+ staining (small aggregates of PAS+ macrophages are nonspecific) or PCR
  • Gram stain: gram+ bacteria
Case reports
  • IV penicillin and streptomycin or third generalization cephalosporin for 10 - 14 days, plus cotrimoxazone for 1 year
Microscopic (histologic) description
  • Nodal architecture obscured by ill defined lipogranulomas
  • Involvement of sinuses by macrophages with foamy cytoplasm
Microscopic (histologic) images

Contributed by Dr. Mark R. Wick

Various images

PAS stain

Warthin-Starry stain

Positive stains
Negative stains
Electron microscopy description
  • Rod-like organisms
Electron microscopy images

Images hosted on other servers:

Trilaminar cell wall

Molecular / cytogenetics description
Differential diagnosis
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