nodular lymphoid hyperplasia
nodular lymphoid hyperplasiaA bone marrow finding variously defined as:
(1) The presence of ≥ 4 normal lymphoid aggregates (average size 0.3 mm) in any low-power (40x) light microscopic field; or
(2) An enlarged (> 0.6 mm) lymphoid nodule.
Nodular lymphoid hyperplasia occurs in up to 60% of bone marrow specimens, at autopsy and, when extreme, mimics a lymphoproliferative process.
ITP, rheumatoid arthritis, cirrhosis, hyperthyroidism, anaemia (autoimmune, haemolytic, drug-related, iron deficiency, and refractory), macroglobulinaemia, Hodgkin lymphoma, large-cell lymphoma, and cryoglobulinaemia.
CLL, primary small-cell lymphoma, well-differentiated lymphoma.
nodular lymphoid hyperplasia (small intestine)The presence in younger (< age 30) adults of multiple submucosal lymphoid aggregates with prominent germinal centres, most common in the small intestine, but which also occurs in the stomach and the large intestine. In children, NLH may be nonspecific; in adults it is usually pathological and associated with defects in humoral immunity—e.g., selective IgA deficiency, common variable immune deficiency/ hypogammagolulineamia, HIV infection. It may occur in absence of humoral immune defects in patients with giardiasis.
Range from mild GI discomfort (in IgA deficiency) to severe malabsorption, chronic diarrhoea, recurrent bacterial infections with sinusitis, bronchitis, bronchiectasis, pneumonia (in CVID). Recurrent infections seen in NLH Campylobacoccidiangardiasis, cryptosporidiosis.