Diagnosis Of Reactive Lymphoid Hyperplasia Research Articles

Effect of Total Macroscopical Sampling of the Pediatric Appendectomy Specimen on Histopathological Diagnosis

Introduction: Acute appendicitis is considered the most common abdominal surgery in children. Pathological examination of the appendectomy specimen mainly is performed to document the presence or absence of inflammation and confirm the clinical diagnosis. If the diagnosis made by the pathologist is as ‘no appendicitis’, then clinical work up for other causes should be performed. Routine macroscopic evaluation of the appendectomy specimen consists of obtaining one section each from the base, body and the tip of the appendix and additional sections obtained from exuding or perforated areas. The aim of this study is to evaluate if the final pathological diagnosis would change when the appendectomy specimen is sampled totally. Materials and Methods: In the present study, we performed conventional macroscopical sampling from the tip, body and base of the appendix and embedded these tissues in the first two cassettes, then the rest of appendix was completely sampled in additional two to five casettes. The histopathological diagnosis of conventionally sampled tissues and the histopathological diagnosis of total macroscopical sampling were analyzed and compared. Results: A total of 87 appendectomies were evaluated, of which 58.6 % were male, and the mean age was 11.7 (1 years-18 years). The initial histopathological diagnosis was changed in 14 (16%) cases. In 8 (9.2%) cases, the initial diagnosis of reactive lymphoid hyperplasia changed to acute focal appendicitis (early appendicitis). In 4 (4.6%) cases the initial diagnosis of acute suppurative appendicitis changed to acute suppurative and perforated appendicitis, and in 2 (2.2%) cases acute perforated appendicitis changed to acute perforated and gangrenous appendicitis. Conclusion: Total macroscopical sampling of the appendectomy specimen in cases of negative appendicitis would improve the diagnosis and can document early appendicitis in pediatric cases.

Kappa and lambda immunohistochemistry and in situ hybridization in the evaluation of atypical cutaneous lymphoid infiltrates.

Atypical cutaneous lymphoid infiltrates are challenging lesions in dermatopathology. We present a summary of the literature regarding kappa and lambda immunohistochemistry (IHC) and in situ hybridization (ISH) in the evaluation of atypical cutaneous or mucosal lymphoid infiltrates. Relevant articles from 1967 to 2018 in the English language were identified and summarized. In the absence of larger studies, case series of n ≥ 3 were included. Sixty-three articles assessing kappa and lambda IHC and/or ISH were identified. Most focused on marginal zone lymphomas. Other lymphomas included follicle center lymphoma, diffuse large B-cell lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, mantle cell lymphoma, lymphoplasmacytic lymphoma, plasmablastic lymphoma, multiple myeloma, monoclonal gammopathy of undetermined significance, and polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes (POEMS). Non-neoplastic lesions included reactive lymphoid hyperplasia, cutaneous plasmacytosis, connective tissue disease, IgG4-related disease, acrodermatitis chronic atrophicans, Zoon balanitis, dermatitides, and infiltrates around epithelial dysplasias/neoplasias. Kappa and lambda IHC and ISH are useful tools in the evaluation of cutaneous B-cell lymphomas and plasma cell neoplasms. The literature supports that the detection of light-chain restriction by IHC and ISH is one of the most useful findings in the differential diagnosis of reactive lymphoid hyperplasia vs B-cell lymphoma with plasmacytic differentiation.

Reactive lymphoid hyperplasia of the liver. A case report

Reactive lymphoid hyperplasia of the liver is an unusual benign lesion of unknown pathogenesis. The largest reported series to date includes only 7 cases.Reactive lymphoid hyperplasia can be radiologically confused with malignant tumors such as hepatocellular carcinoma or metastases. Histological differential diagnosis should be chiefly made with lymphomas, Castleman disease and primary biliary cirrhosis.We report the clinicopathological findings in a 54-year-old woman with an incidental hepatic lesion when she consulted for hematuria. After histological, immunohistochemical and molecular studies, the diagnosis of reactive lymphoid hyperplasia was made.

Reactive lymphoid hyperplasia of the thyroid followed by systemic autoimmune diseases: a case report

IntroductionReactive lymphoid hyperplasia is a benign nodular lesion characterized by marked proliferation of non-neoplastic, polyclonal lymphocytes forming follicles. The lesion is found in various organs such as skin, orbit, lung, gastrointestinal tract, and liver. However, reactive lymphoid hyperplasia in the thyroid gland is extremely rare. Here, we present an interesting case of reactive lymphoid hyperplasia in the thyroid, which suggests the nature of the disease.Case presentationA 74-year-old Japanese man was referred to our institute because of a growing well-demarcated irregular-shaped mass in the right lobe of the thyroid. Malignant lymphoma was suspected by cytology, and right lobectomy was conducted. A final diagnosis of reactive lymphoid hyperplasia was made by the intimate investigation of the surgical specimen, with evidence of polyclonal and non-neoplastic lymphatic proliferations forming follicles with an active germinal center. After an initial uneventful postoperative course, our patient developed severe symptoms of systemic rheumatic arthritis, and alterations in autoimmune reaction, including clinically overt chronic thyroiditis, were identified.ConclusionsOur case demonstrated important clinical information on reactive lymphoid hyperplasia of the thyroid, and suggested the importance of differential diagnosis, and possible close correlation between systemic autoimmune disorder and the disease.

Ocular adnexal reactive lymphoid hyperplasia in children

Aim:To describe the clinical and histopathological features of ocular reactive lymphoid hyperplasia in children, and review the literature regarding this entity.Materials and Methods:In this retrospective, interventional case series, a chart review was performed of three patients diagnosed with reactive lymphoid hyperplasia. Details of clinical presentation, ocular and systemic examination findings, management and subsequent course were noted.Results:Three children, aged 9–14 years presented with ocular adnexal masses (two unilateral and one bilateral) with 7–12 months duration. Ocular examination revealed discrete nasal conjunctival masses in two patients, and bilateral eyelid fullness and conjunctival chemosis in the third patient. Systemic evaluation and laboratory tests were normal in all patients. Orbital imaging showed lacrimal gland enlargement in one patient. Histopathological evaluation with immunohistochemical markers established the diagnosis of reactive lymphoid hyperplasia. Two patients underwent surgical excision with complete resolution. All patients have remained stable and at their last follow-up have showed no evidence of recurrence, transformation, or systemic involvement.Conclusion:Reactive lymphoid hyperplasia, though uncommon in children, can have a favorable outcome with timely intervention

Diagnosis of Reactive Lymphoid Hyperplasia by Chorioretinal Biopsy

We treated a patient with reactive lymphoid hyperplasia in whom the diagnosis was made by chorioretinal biopsy. Histopathologic examination and culture of the biopsied specimen allowed us to rule out a neoplastic or infectious process. The biopsy result allowed us to treat him with systemic corticosteroid alone, thus avoiding the potential harmful side effects of other medications, including antituberculous drugs. There were no surgical or postoperative complications. This study confirms the usefulness of chorioretinal biopsy for establishing a diagnosis and formulating a rational treatment plan.

Diagnosis of primary early gastric lymphoma. Usefulness of endoscopic mucosal resection for histologic evaluation

Eight patients thought to have primary early gastric lymphoma were studied to evaluate the usefulness of endoscopic mucosal resection for the diagnosis of reactive lymphoid hyperplasia (RLH) or malignant lymphoma. In these patients, conventional endoscopic forceps biopsy did not provide a definite histologic diagnosis. Endoscopic ultrasonography (EUS) demonstrated that the disease was limited to the mucosa and the submucosa in all patients, without any paragastric lymph node involvement, so endoscopic mucosal resection was performed to obtain specimens large enough to include the submucosa. As a result, primary early gastric lymphoma was diagnosed in five patients, for whom subsequent gastrectomy confirmed the diagnosis. The authors recommend that endoscopic mucosal resection be performed in patients thought to have primary early gastric lymphoma and for whom a definite diagnosis can not be made by conventional endoscopic forceps biopsy.