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Background
The lymph node are the sentinels of the lymphatic system. Its primary role is produce a response to foreign particles or antigens. Lymph nodes are distributed throughout the body receiving lymphatic fluid from the lymphatic vessels. Within the lymph node, there are several compartments, each with specialized functions.
LYMPH NODE COMPARTMENT FUNCTION Follicle or germinal center Formation of precursors of antibody-forming cells and memory B cells Medullary cords Plasma cell reaction with formation of antibody secreting B cells Paracortex Specific cellular response with generation of antigen-specific T-cells and memory T-cells Sinuses Macrophages clear the lymph and process antigens OUTLINE
Histopathological Features and Variants Infarction Commonly Used Terms Internet Links
HISTOLOGICAL TYPES CHARACTERIZATION GENERAL BREAST IMPLANTS
- Pathology of Lymph Nodes From Patients With Breast Implants: A Histologic and Spectroscopic Evaluation.
Katzin WE, Centeno JA, Feng LJ, Kiley M, Mullick FG.
From the Departments of *Pathology and double daggerSurgery, Case Western Reserve University School of Medicine, Cleveland, OH; and daggerDepartment of Environmental and Infectious Disease Sciences, Armed Forces Institute of Pathology, Washington, DC.
Am J Surg Pathol. 2005 Apr;29(4):506-511. Abstract quote
There are only a few published reports describing the pathology of regional lymph nodes from patients with silicone breast implants. Systematic analytical chemical verification of foreign material has not previously been reported.
In this study, biopsies of regional lymph nodes from 96 patients with breast implants were studied using conventional histology as well as laser-Raman microprobe spectroscopy and Fourier transform infrared microspectroscopy.
Lymph nodes from 12 patients without implants served as negative controls. Foamy macrophages, ranging from rare scattered cells to confluent sheets, were observed in sections of lymph nodes from 91 patients with implants and only rare foamy macrophages were observed in sections from 4 patients without implants. Refractile material consistent with silicone was observed in sections from 86 patients with implants and in no sections from patients without implants. Fragments of foreign material consistent with polyurethane were observed in sections from 16 patients with implants and in no sections from patients without implants. Using spectroscopy, the presence of silicone was confirmed in 71 patients with implants, and the presence of polyurethane was confirmed in 2 patients with implants. Spectroscopy was negative for silicone and polyurethane in all patients without implants.
In summary, regional lymph nodes from patients with breast implants often have histologic evidence of silicone migration. Characteristic histologic findings include foamy macrophages and refractile droplets of clear material. Polygonal fragments of polyurethane were observed in lymph nodes from a number of patients.
This finding has not been previously reported. The presence of silicone and polyurethane was confirmed using confocal laser-Raman microprobe and Fourier transform infrared microspectroscopy. Other than two prior case reports, this is the first confirmatory evidence of silicone migration to lymph nodes in patients with breast implants and this is the first confirmatory report of polyurethane migration to lymph nodes.INFARCTION
Lymph Node Infarction.Strauchen JA, Miller LK.
Department of Pathology, Mount Sinai School of Medicine, New York, NY.
Arch Pathol Lab Med 2003 Jan;127(1):60-63 Abstract quote Context.-The etiology of lymph node infarction may be difficult or impossible to determine by histologic examination. Lymph node infarction is followed by malignant lymphoma in some but not all patients. The role of immunohistochemistry in the evaluation of lymph node infarction is not well defined. Although it is widely believed that necrotic tissue is not suitable for immunohistochemical study, this view may be inaccurate.
Objective.-To determine whether lymphoid antigens are preserved in infarcted lymph nodes and to determine the utility of immunohistochemical staining in the evaluation of lymph node infarction.
Design.-Retrospective immunohistochemical study of infarcted lymph nodes using archival formalin-fixed, paraffin-embedded tissue. Setting.-Academic medical center.
Patients.-Eleven adult patients with lymph node infarction retrieved from pathology files.
Main Outcome Measures.-Results of immunohistochemistry, diagnosis of lymphoma.
Results.-Preservation of lymphoid antigens was observed in 4 of 6 cases of lymph node infarction associated with malignant lymphoma, including 3 of 5 cases of diffuse large B-cell lymphoma and 1 case of peripheral T-cell lymphoma. Nonspecific staining was not encountered. In 1 case, in which an infarcted lymph node showed a benign pattern of lymphoid antigen expression, lymphoma has not developed after 5 years.
Conclusion.-Lymphoid antigens are frequently preserved in cases of lymph node infarction, and immunohistochemical study of infarcted lymph nodes may provide clinically useful information.
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Weedon D. Weedon's Skin Pathology Second Edition. Churchill Livingstone. 2002
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Basic Principles of Disease
Learn the basic disease classifications of cancers, infections, and inflammation
Commonly Used Terms
This is a glossary of terms often found in a pathology report.Diagnostic Process
Learn how a pathologist makes a diagnosis using a microscopeSurgical Pathology Report
Examine an actual biopsy report to understand what each section meansSpecial Stains
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Last Updated 1/5/2004
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