follicular hyperplasia

follicular hyperplasia

A reactive pattern seen in benign lymphadenopathy that consists of idiopathic expansion of lymphoid follicles (germinal centres containing centroblasts, centrocytes and follicular dendritic cells), which is seen in lymph nodes with chronic nonspecific lymphadenitis.
 
Aetiology
Infections that evoke B-cell response (e.g., HIV), SLE, toxoplasmosis, leishmaniasis, syphilis, adult-onset Still’s disease, Felty syndrome.

DiffDx
Follicular hyperplasia is normal in children, but may also occur in Castleman’s angiofollicular hyperplasia, follicular lymphoma, lymphocyte predominant Hodgkin lymphoma, progressive transformation of germinal centres.
References in periodicals archive ?
Reactive lymph nodes were excluded, such as florid follicular hyperplasia and reactive changes confirmed or clinically suspected from viral etiology, autoimmune disease, dermatopathic origin, and other nonmalignant pathologic diagnoses.
2) Proliferation of follicular dendritic cells occurs in a number of reactive and neoplastic conditions, including reactive follicular hyperplasia, follicular lymphoma, mantle cell lymphoma, nodular lymphocyte-predominant Hodgkin's lymphoma, and angioimmunoblastic T-cell lymphoma.
Specifically, infectious mononucleosis caused by EpsteinBarr virus may present with architectural effacement or alteration due to marked paracortical expansion by proliferation of immunoblasts, follicular hyperplasia with characteristic mottled edges, prominent monocytoid B cells, abundant plasma cells, and varying degrees of necrosis.
Their characteristic histologic features include preserved nodal architecture, florid follicular hyperplasia with reactive germinal centers, protein and IgE deposits in germinal centers, germinal center necrosis, eosinophilic infiltrates, proliferation of post-capillary venules, sclerosis, polykaryocytes, eosinophilic folliculolysis, and prominent eosinophilic microabscesses (figure).
Strict criteria must be used in the diagnosis of FLs in children, to differentiate them from the much more frequently occurring reactive follicular hyperplasia (Figure 1, A and B).
Of the 15 cases of reactive lymph nodes, 6 were diagnosed with reactive follicular hyperplasia, 4 with paracortical hyperplasia, 3 with mixed hyperplasia, and 2 with sinus histiocytosis.
3%) contained reactive lymphoid hyperplasia; follicular hyperplasia (13.
The most common histologic features of Kimura disease include preserved nodal architecture (Figure 1); follicular hyperplasia with reactive germinal centers; well-formed mantle zones; eosinophilic infiltrates involving the inter-follicular areas (Figure 2), sinusoidal areas, perinodal soft tissue (Figure 3), and subcutaneous tissue; and proliferation of postcapillary venules.
Frozen-section analysis revealed an atypical follicular hyperplasia, with microabscesses and multinucleate polykaryotic cells.
All of the lymph nodes (n = 120) from the HIV-seronegative control patients showed lymphoid follicular hyperplasia with variable degrees of sinus histiocytosis in the lymph nodes from 5 of the 28 patients.
Colonic biopsies showed marked melanosis coli (Figure 2) with multiple foci of lymphoid follicular hyperplasia corresponding to the white nodular patches distributed throughout the colon and rectum (Figure 3).

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