Background some patients with systemic lupus erythematosus sle have lymphadenopathy lap at diagnosis or at followup. Fine needle aspiration cytology of dermatopathic lymphadenitis. Dermatopathic lymphadenopathy with increased igg4positive p. A case of dermatopathic lymphadenopathy associated with hypereosinophilic syndrome dear editor, a 42yearold man presented with a 4week history of erythematous, maculopapular rash over his whole body fig. Dl, also known as lipomelanotic reticulosis or pautrierworinger disease, represents a rare form of benign lymphatic hyperplasia associated with most exfoliative or eczematoid inflammatory erythrodermas, including pemphigus, psoriasis, eczema, neurodermatitis, and atrophia senilis. The marked paracortical expansion by lymphocytes, dendritic cells, and histiocytes, seen in tissue sections as large pale nodules, is undetectable in smears. The atlas features an overview of the benign reactive processes secondary to infectious, environmental or unknown insults, as well as relevant.
We present the case of a 48yearold civil servant with axillary lymphadenopathy discovered on routine mammography. Dermatopathic lymphadenopathy asano 1987 pathology. Riegel, do, ehrling bergquist family medicine residency program, offutt. Roval postgraduate medical school, du cane road, london w12 ohs and. Dermatopathic lymphadenitis also known as lipomelanotic reticulosis, or pautrierworinger disease is a rare type of benign lymphatic hyperplasia associated with a variety of exfoliative or eczematoid type inflammatory erythrodermas. Bardales, lymph node cytopathology, isbn, page 104. Angiomyomatous hamartoma of lymph nodes is associated with. Dermatopathic lymphadenopathy lymphadenitis dermatopathic. F18 fdg petct imaging showed intensely fdgavid lymph nodes in the cervical, axillary, and inguinal. Jun 22, 2018 panel a florid dermatopathic lymphadenopathy is characterized by paracortical expansion by small lymphocytes, histiocytes, and langerhans cells a1.
Tattoo lymphadenopathy could be considered a specialized case of dermatopathic lymphadenopathy, which has been reported as a result of allergy to a foreign substance. Follicular lymphoid hyperplasia is present in the early stages of dermatopathic lymphadenopathy, and smears show lhas, a polymorphous lymphocyte population, and variable numbers of figure 7. However, the presence of lap and their histological type may have clinical relevance. Atlas of lymph node pathology roberto miranda springer. We present a case of a 43yearold male presented with 3 months history of fatigue, fever, and lymphadenopathy. Files are available under licenses specified on their description page. Diagnosis of dl depends on the histopathologic characteristics of paracortical t zone expansion with melanin, hemosiderin, or lipidladen macrophages.
Dermatopathic lymphadenopathy represents the reaction of a superficial lymph node to the drainage of skin antigens and melanin from various chronic dermatoses indeed, in the present study, idc of dermatopathic lymphadenopathies expressed these five markers, whereas the majority of normal intraepidermal lc did not. Size, where lymphadenopathy in adults is often defined as a short axis of one or more lymph nodes is greater than 10mm. There are various groups or chains of lymph nodes mostly located along the lateral borders of the neck. Ab0547 lymphadenopathy in systemic lupus erythematosus. Dermatopathic lymphadenopathy an overview sciencedirect. A case of dermatopathic lymphadenopathy associated with. This is often suspicious for malignancy, leading to biopsy. Find out information about dermatopathic lymphadenopathy. All structured data from the file and property namespaces is available under the creative commons cc0 license.
Clinical, histopathologic, and immunoarchitectural features of. Clinical implication of dermatopathic lymphadenopathy. Dermatopathic lymphadenopathy article about dermatopathic. Dermatopathic lymphadenopathy is a distinctive type of paracortical hyperplasia in which interdigitating dendritic cells are greatly increased. Lymphadenopathy or adenopathy is disease of the lymph nodes, in which they are abnormal in size or consistency. To our knowledge, this is the first flis reported from west africa. Histopathologic evaluation of a right supraclavicular node showed pigment laden macrophages which stained positive for melanin with fontanamasson. Soeprono teaches and practices dermatopathology at loma linda university, school of medicine, department of dermatology. Dermatopathology reference describes dermatopathic lymphadenopathy histopathology including histologic features and provides links to additional medical references.
Pdf dermatopathic lymphadenitis in a patient with pemphigus. We also report for the first time the association with dermatopathic lymphadenopathy in 87. These changes are usually associated with skin disease. Dermatopathic lymphadenopathy is a distinctive type of paracortical. Pdf fine needle aspiration cytology of dermatopathic. Some patients with mild dermatopathic lymphadenopathy do not have skin disease or other discernible etiologies to explain the lymph node findings. Dermatopathic lymphadenopathy definition reactive paracortical hyperplasia of lymph node characterized by an increased number of interdigitating dendritic cells, langerhans cells, and histiocytes with cytoplasmic melanin deposits and lipid vacuoles. In pathology, dermatopathic lymphadenopathy, is lymph node pathology due to skin disease. Histopathology of lymph nodal tuberculosis university. Dermatopathic lymphadenopathy dpl is characterized by lymph node enlargement with reactive process and is generally caused by chronic inflammatory skin disease.
Histopathology lymph node excision n 91 or biopsies from extranodal tissues n 33 were performed in 124 of 396 patients. Riegel, do, ehrling bergquist family medicine residency program, offutt air force base, nebraska l. On histology, a predominant reactive change with aggregates of. Dermatopathic lymphadenitis definition of dermatopathic. Kualu lumpur abstract fiftynine cases of tuberculous cervical lymphadenitis were analysed histologically. A case report banushree c srinivasamurthy, kaushik saha, swagatika senapati, arpita saha department of pathology and laboratory medicine, all india institute of medical sciences, bhubaneswar, odisha, india. An introduction to the lymph node is in the lymph nodes article haematologic malignancies in lymph nodes are dealt with in other articles see haematopathology and lymphoma. Dermatopathic lymphadenopathy is a nonspecific nodal enlargement associated with many chronic dermatoses, including psoriatic erythroderma, exfoliative dermatitides, and mycosis fungoides. A white paper by the american college of radiologys incidental findings committee ii addressed the challenge faced by radiologists who must advise clinicians on the significance of incidentally noted lymph nodes in the abdomen and pelvis. The disorder is either generalised or confined to the tributary area. Dermatopathic lymphadenitis dl is a reactive lymphoid hyperplasia that commonly involves the regional lymph nodes in patients with chronic dermatoses, such as exfoliative dermatitis, toxicshock.
Pathology of the cervical lymph nodes lymphadenopathy. Dermatopathic lymphadenopathy with increased igg4positive. Reactive marrow atypical lymphoproliferative disorders published date. Synonym of dermatopathic lymphadenitis 2010, stefan e. Panel a florid dermatopathic lymphadenopathy is characterized by paracortical expansion by small lymphocytes, histiocytes, and langerhans cells a1.
Irregularly shaped pale staining areas extending from the capsule into deeper areas of the node are typical of dermatopathic lymphadenopathy. Mycosis fungoides mf is the most common type of cutaneous tcell lymphoma ctcl and represents nearly 50% of all primary cutaneous lymphomas. The pallor is due to histiocyte proliferation in the paracortical regions of the node. Infections can either originate from the organs that they drain or primarily within the lymph node itself, referred to as lymphadenitis. Haematologic malignancies in lymph nodes are dealt with in other articles see haematopathology and lymphoma. Mycosis fungoides american journal of clinical pathology. The study cohort was 50 lymph node samples from 42 patients diagnosed with dermatopathic lymphadenopathy.
Thirtythree biopsies showing dermatopathic lymphadenopathy were obtained form patients with documented cutaneous mycosis fungoides and were studied together with an equal number of dermatopathic lymph nodes derived from patients without evidence of mycosis fungoides. It has a characteristic pattern of histomorphology and immunohistochemical staining. Toluidine blue staining was also performed to identify mast cells. The patients included 29 women and men with a median age of 49 years range, 1279. Enlargement or disease of lymph nodes explanation of dermatopathic lymphadenopathy. On histologic examination, the affected lymph nodes contain melanin and fatladen reticular cells. There are various methods of grouping and naming them. Dermatopathic lymphadenitis in a patient with pemphigus vulgaris. Jun 26, 20 dermatopathic lymphadenopathy is a distinctive reaction pattern in lymph nodes characterized by paracortical hyperplasia composed of interdigitating dendritic cells idc, langerhans cells lc, macrophages containing melanin pigment, and small tcells. Request pdf clinical, histopathologic, and immunoarchitectural features of dermatopathic lymphadenopathy.
A common feature of dermatopathic lymphadenopathy is the presence of pigment granules. Follicular lymphoma in situ flis is a recently described entity with few cases recognized worldwide. Dermatopathic lymphadenopathy is a distinctive reaction pattern in lymph nodes characterized by paracortical hyperplasia composed of interdigitating dendritic cells idc, langerhans cells lc, macrophages containing melanin pigment, and small tcells. Cervical lymphadenopathy or a pathology affecting the lymph nodes located in the cervical or neck region. Dermatopathic lymphadenopathya clinicopathologic analysis of. The noun dermatopathic lymphadenopathy can be countable or uncountable in more general, commonly used, contexts, the plural form will also be dermatopathic lymphadenopathy however, in more specific contexts, the plural form can also be dermatopathic lymphadenopathies e. Ss, categorized as a separate entity from mf by the whoeortc classification system, is an aggressive disease with a poor prognosis. Chronic lymphadenopathy lasting greater than 6 weeks or persistent enlargement of a single lymph node, regional lymph node group or systemic lymphadenopathy in the absence of an obvious cause are indications for lymph node biopsy or excision. An introduction to the lymph node is in the lymph nodes article.
Department of immunology, royal free hospital, pond street, london n w 3 2qc dermatopathic lymphadenopathy dl is a benign reactive lymph node enlargement secondary to chronic inflammatory skin diseases. Dermatopathic lymphadenitis in a patient with pemphigus. Dermatopathic lymphadenopathy a clinicopathologic analysis of lymph node biopsy over a fifteenyear period. Dermatopathic lymphadenopathy dpl is characterized by lymph node enlargement. Initial workup satisfactorily met the criteria for diagnosis of aosd. What is the plural of dermatopathic lymphadenopathy. Clinical, histopathologic, and immunoarchitectural. Clinical implication of dermatopathic lymphadenopathy among. The axillary and inguinal regions are most commonly affected, although occasionally it can present in the head and neck as well. Dermatopathic lymphadenopathy is diagnosed by a lymph node biopsy.
Pdf on nov 26, 2015, na hu and others published dermatopathic. Sep 05, 2016 dermatopathic lymphadenopathy usually occurs with skin diseases, either benign or malignant, and many patients have pruritus. This article deals with nonhaematologic malignant, i. Axillary and inguinal lymph nodes are most commonly affected. There superficial palpable and deep not easily palpable groups. No increase in interdigitating reticulum cellslangerhans histiocytes. The term lymphadenopathy conveys a message of abnormality to the patient and clinician. Histopathology grossly, the cut surface of an excised lymph node may be yellow or tan with occasional brown, pigmented foci. Various atypical or malignant lymphoproliferative disorders exhibiting immunologic abnormalities such as angioimmunoblastic tcell lymphoma or autoimmune disease. Reaction to drainage of melanin and various skin antigens. Fine needle aspiration cytology of dermatopathic lymphadenitis article pdf available in acta cytologica 426.
In fact, up to 80% of patients with igg4rd are found to have localized or systemic lymphadenopathy on imaging. An axillary lymph node from a patient with psoriasis is shown. The changes present appear to be reactive to an as yet unknown stimulus and propose the term dermatopathic angiomyomatousrelated hyperplasia darh to describe this entity. Florid dermatopathic lymphadenopathya morphological mimic of. Lymphadenopathy of an inflammatory type the most common type is lymphadenitis, producing swollen or enlarged lymph nodes. Dermatopathic lymphadenopathya clinicopathologic analysis. Dermatopathic lymphadenitis is rare indian j sex transm dis 2009. The histologic development and progression of the disease was correlated. As such, they are most readily palpable when fighting infections. Histologically, in addition to the dermatopathic lymphadenopathy, numerous immunoblasts were observed in 2 cases and sheetlike proliferation of mature plasma cells in 3 cases. Soepronos textbook is available on and includes detailed information on over 600 entities and includes four dvd diskettes with highresolution images that provide a virtual dermatopathology reference and guide. Florid dermatopathic lymphadenopathya morphological mimic. First department of pathology, fukushima medical college, fukushima.
Dermatopathic lymphadenopathy definition of dermatopathic. Nov 20, 2015 dl, also known as lipomelanotic reticulosis or pautrierworinger disease, represents a rare form of benign lymphatic hyperplasia associated with most exfoliative or eczematoid inflammatory erythrodermas, including pemphigus, psoriasis, eczema, neurodermatitis, and atrophia senilis. Follicular lymphoma in situ presenting as dermatopathic. The prevalence of lap in sle was 59% in the oldest series,1 12% in the 1993 eurolupus series2 and in the last two decades its prevalence was not mentioned. This is a case of a 10yearold boy with a history of severe eczema, who presented with enlarged lymph nodes.