Lymph nodes & spleen, nonlymphoma

Spleen-infectious / inflammatory disorders

Follicular hyperplasia

Last author update: 1 October 2012
Last staff update: 12 May 2021

Copyright: 2003-2022,, Inc.

PubMed Search: Follicular hyperplasia spleen[TIAB]

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Cite this page: Mansouri J. Follicular hyperplasia. website. Accessed August 11th, 2022.
Definition / general
  • Also called reactive follicular hyperplasia
  • Focal or diffuse
  • Normal in children
  • In adults, due to systemic infection (malaria, measles, typhoid fever, virus, other), immune mediate disorders (hemolytic anemia, immune thrombocytopenic purpura, rheumatoid arthritis)
  • Often associated with congestion and plasmacytic proliferation
  • Associated with hypersplenism in Zaire, Nigeria and New Guinea, where spleens also show extramedullary hematopoiesis and marked sinusoidal dilation; may be related to malaria
  • Note: graft rejection and AIDS are associated with reactive nonfollicular hyperplasia, which may resemble lymphoma but has heterogeneous lymphocytic population without atypia and without clonality
  • Felty syndrome (rheumatoid arthritis): no granulocytic phagocytosis but expansion of red pulp cords and sinuses with macrophages
Gross description
  • May have enlarged spleen with multiple small, pale tan nodules or solitary large nodules resembling lymphoma (Am J Surg Pathol 1983;7:373)
Microscopic (histologic) description
  • Resemble nodal reactive follicles, with mixed follicular center population and tingible body macrophages
  • Usually mature lymphocytes and plasma cells in red pulp
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