淋巴结炎症与淋巴结萎缩及淋巴瘤如何鉴别？

Than\k you ! Your explain are very well .

 Some enlarged LNs show a predominance of secondary lymphoid follicles that are small, but 

still maintain the stromal organization of the GC. Such “Castlemanoid” or regressed follicles 

are composed predominantly of FDCs and are depleted of GC B cells and tingible body mac-

rophages, suggesting that the process of follicular proliferation has largely ceased. Mantle 

zones are preserved or even prominent, and some cases show interfollicular immunoblastic 

proliferation indicative of ongoing antigenic stimulation. Causes of lymphadenitis with such 

prominent regressed follicles include nodal irradiation, prolonged immune stimulation, and 

the hyaline vascular variant of Castleman disease (HVCD), which is a benign but possibly 

clonal disorder of FDC. Definitive features of HVCD, in addition to localized lymphadenop-

athy and regressed follicles (Fig. 12-9), include prominent interfollicular HEV, proliferations 

of plasmacytoid DCs, and partial or complete loss of subcapsular sinuses due to expansile 

compression. One variant of follicular lymphoma, particularly common in intraabdominal 

and pelvic LNs, can show a predominance of regressed follicles simulating HVCD.

Other patterns of reactive GC dissolution include  follicular lysis, necrosis of follicles, 

and formation of granulomas within GCs. Follicular lysis is usually found in HIV+ patients 

with high viral titers and is characterized by invasion of CD8+ cytotoxic T cells into the GC. 

Necrosis of follicles is occasionally seen in children with severe bacterial infections, prob-

ably caused by cytolytic attack against lymphocytes or APCs containing bacterial antigens.

把握淋巴结的基本结构。炎症的基本概念，萎缩的基本概念和淋巴瘤的基本概念。概念掌握了就OK了

简单的几句话很难回答，请您把淋巴结病变章节仔细阅读会有初步体会。