Fine needle aspiration cytology (FNAC) revealed many small to medium lymphocytes, a few large lymphocytes with mild nuclear atypia and increased chromatin and a few tingible body macrophages
. The lesion was Class III according to the Papanicolaou classification.
Usually, D-FL appears as several well-circumscribed germinal centers packed together with centrocytes and few, if any, centroblasts with no visible tingible body macrophages
and without mantle zones.
The residual lymph node showed reactive germinal centers and tingible body macrophages
, but no hemophagocytosis (Figure 1).
Reactive lymphadenitis was second most common finding with 13(26%) cases showing predominantly small lymphocytes, transforming lymphocytes, centrocytes, centroblasts, tingible body macrophages and few histiocytes.
Reactive lymphadenitis was second most common finding 14(28%) showing small lymphocytes, transforming lymphocytes, centrocytes, centroblasts, tingible body macrophages and few histiocytes.
The tumor tissue contained tingible body macrophages
with nuclear debris.
In addition, tingible body macrophages
contain "ingested nuclear debris, which represents lymphocytes that have been selected to be destroyed in reactive follicles.
Secondary follicles form when primary follicles react to antigen stimulation and are characterized by a peripheral mantle zone of small mature B cells surrounding a central germinal center made up of antigen-selected centroblasts and centrocytes that segregate into polarized dark and light zones, respectively, with admixed tingible body macrophages and follicular dendritic cells (Figure 1, C).
Reactive follicles may show variability in size and shape but typically exhibit polarized germinal centers that are made up of centroblasts and centrocytes with admixed tingible body macrophages and small mature lymphocytes, which are cuffed by well-formed and defined mantle zone (Figure 2, B and C).
Smears from fine needle aspiration of the mass lesion predominantly showed small and large lymphocytes, tingible body macrophages
admixed with fibrotic strands in haemorrhagic background (Figure 2 A and B).
The monoclonal antibody HAM56 labels bloodborne tissue macrophages such as hepatic Kupffer cells and pulmonary alveolar macrophages in addition to tingible body macrophages
and interdigitating macrophages of lymph nodes.