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Cervical lymphadenopathy

panzenggang 离线

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楼主 发表于 2009-12-10 09:50|举报|关注(0)
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姓    名: ××× 性别:  Male 年龄:  9 years
标本名称:  Cervical lymph node
简要病史:  9 years old male. Right cervical lymphadenopathy for several months. Image studies showed several enlarged lymph nodes 1.1 - 1.7 cm within the right cervix. His CBC was within normal limit.
肉眼检查:  
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Cervical lymphadenopathy图10
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arhus 离线

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1 楼    发表于2009-12-10 09:55:00举报|引用
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 Rosai-Dorfman's disease.
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月儿 离线

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2 楼    发表于2009-12-10 16:57:00举报|引用
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 典型,图好漂亮!
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panzenggang 离线

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3 楼    发表于2009-12-23 10:49:00举报|引用
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IPX:  S100+, CD68+, CD1a- 

Diagnosis: Rosai-Dorfman's disease.

Rosai-Dorfman Disease

 
  • Also named "sinus histiocytosis with massive lymphadenopathy", unknown etiology.

  • Clinical

    • Common in young males, mean age 20.6 years, African-Americans.

    • Leukocytosis, moderate polyclonal hypergammaglobulinemia in most cases.

    • Mostly in cervical LNs, can involve other LNs or extranodal.

    • Painless strikingly enlarged LN.

    • Spontaneous remission in majority

  • Histology:

    • Marked sinus expansion filled with lymphocytes, plasma cells, and histiocytes.

    • SHML cells: large and irregularly shaped, abundant acidophilic vacuolated cytoplasm, one nucleus, a central nucleolus.

    • Emperipolesis: The intracytoplasmic vacuoles of SHML cells contain engulfed cells, as many as 20 cells, usually lymphocytes, plasma cells, or erythrocytes. The engulfed cells are usually contained in an intracytoplasmic vacuole. Some cells, particularly lymphocytes in the vacuoles, are viable; others are degraded, often forming nuclear fragments.

    • Lack of mitoses or necrosis.

  • IPX: CD14+, CD68+, HLA-DR+, S100+, CD1a-.

  • DDX:

    • Sinus histiocytosis: no lymphophagocytosis, S100-.

    • ALCL: atypia, T-cell origin, CD30+,  S100-.

    • LCH: nuclear grooves, eosinophilia, S100+ and CD1a+.

Summaried by Zenggang Pan, MD, PhD

For the details, please visit http://www.enjoypath.com/hp/hp-103/hp-103.htm

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4 楼    发表于2009-12-23 19:51:00举报|引用
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 漂亮的图片,谢谢分享!
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5 楼    发表于2009-12-23 20:40:00举报|引用
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 佩服,学习了!
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6 楼    发表于2009-12-24 13:19:00举报|引用
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 非常典型的教学病例.
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