Follicular hyperplasia: Difference between revisions
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Follicular hyperplasia is the most common pattern of reactive lymphadenopathy.<ref name="WeissO'Malley2013">{{cite journal|last1=Weiss|first1=Lawrence M|last2=O'Malley|first2=Dennis|title=Benign lymphadenopathies|journal=Modern Pathology|volume=26|issue=S1|year=2013|pages=S88–S96|issn=0893-3952|doi=10.1038/modpathol.2012.176}}</ref> | '''Follicular hyperplasia''' is the most common pattern of '''[[reactive lymphadenopathy]]'''.<ref name="WeissO'Malley2013">{{cite journal|last1=Weiss|first1=Lawrence M|last2=O'Malley|first2=Dennis|title=Benign lymphadenopathies|journal=Modern Pathology|volume=26|issue=S1|year=2013|pages=S88–S96|issn=0893-3952|doi=10.1038/modpathol.2012.176}}</ref> Reactive follicular hyperplasia is usually associated with varying degrees of paracortical and/or sinus hyperplasia. Older age, increased follicular density (especially back-to-back arrangement) and areas of diffuse nodal effacement leads to a suspicion of '''[[follicular lymphoma]]'''.<ref name="WeissO'Malley2013"/> | ||
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File:Histopathology of reactive follicular hyperplasia.jpg|thumb|Histopathology of reactive follicular hyperplasia | File:Histopathology of reactive follicular hyperplasia.jpg|thumb|Histopathology of reactive follicular hyperplasia | ||
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Main differences:<ref name="WeissO'Malley2013"/> | Main differences:<ref name="WeissO'Malley2013"/> | ||
{|class=wikitable | {|class=wikitable | ||
! Feature !! | ! Feature !! Follicular hyperplasia of a '''[[reactive lymph node]]''' !! '''[[Follicular lymphoma]]''' | ||
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! Density of follicles | ! Density of follicles | ||
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If uncertain, perform the following studies:<ref name="WeissO'Malley2013"/> | If uncertain, perform the following studies:<ref name="WeissO'Malley2013"/> | ||
{|class=wikitable | {|class=wikitable | ||
! Feature !! Reactive | ! Feature !! '''[[Reactive lymph node]]''' !! Follicular lymphoma | ||
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! Bcl-2 in B cells of germinal centers | ! Bcl-2 in B cells of germinal centers | ||
Latest revision as of 17:49, 10 November 2021
Author:
Mikael Häggström [note 1]
Follicular hyperplasia is the most common pattern of reactive lymphadenopathy.[1] Reactive follicular hyperplasia is usually associated with varying degrees of paracortical and/or sinus hyperplasia. Older age, increased follicular density (especially back-to-back arrangement) and areas of diffuse nodal effacement leads to a suspicion of follicular lymphoma.[1]
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Histopathology of reactive follicular hyperplasia
Main differences:[1]
| Feature | Follicular hyperplasia of a reactive lymph node | Follicular lymphoma |
|---|---|---|
| Density of follicles | Low | High |
| Follicle distribution | Usually limited to subcortical region | Distributed evenly throughout parenchyma |
| Follicles extending beyond capsule | Rarely | Often |
| Follicle sizes and shapes | Uneven | Similar |
| Cell types in germinal centers | Mixture of cells | Monomorphic or polymorphic |
| Tingible-body macrophages | Present | Usually rare |
| Mitotic rate | Usually moderate to high | Usually low to moderate |
| Mantle zone | Usually distinct | Usually indistinct or absent |
| Cell polarization | Often seen | Usually absent |
| Interfollicular areas | Large | Compressed |
| Areas of nodal effacement | Absent | Occasional |
If uncertain, perform the following studies:[1]
| Feature | Reactive lymph node | Follicular lymphoma |
|---|---|---|
| Bcl-2 in B cells of germinal centers | Negative | Positive (90%) |
| Light chain restriction on immunostains | Absent (rare exceptions) | Present (20% in paraffin) |
| Light chain restriction on flow cytometry | Absent restriction (rare exceptions) | Restriction or absent, when gated correctly (95%) |
| Ig rearrangements | Absent (rare exceptions) | Usually (80%) |
| t(14;18) | Absent (rare exceptions) | Usually present (90%) |
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
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