Skip to main content
SpringerLink
Log in

Lymph Node

  • Chapter
Essentials of Anatomic Pathology

  • 5200 Accesses

Abstract

This chapter is intended to provide a brief, practical overview of benign and malignant lymph node pathology for the use of pathologists in training as well as pathologists in practice. The basic format is lymphoid hyperplasias organized by morphologic subtype, followed by malignant lymph node pathology largely adhering to the organizational scheme of the WHO Classification of Hematopoietic and Lymphoid Tissues. Finally, there are brief sections on histiocytic and dendritic cell lymph node tumors as well as spindle cell lesions of lymph nodes. We sincerely hope this chapter is helpful on a day-to-day basis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 229.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 449.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Suggested Reading

General

  • Harris NL, Jaffe ES, Stein H, et al. A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood. 1994;84:1361–92.

    PubMed  CAS  Google Scholar 

  • Jaffe ES, Harris NL, Stein H, Isaacson PG. Classification of lymphoid neoplasms: the microscope as a tool for disease discovery. Blood. 2008;112:4384–99.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Swerdlow SH, Campo E, Harris NL, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: International Agency for Research on Cancer; 2008.

    Google Scholar 

  • Warnke RA, Weiss LM, Chan JKC, Cleary ML, Dorfman RF. Atlas of Tumor Pathology: Tumors of the Lymph Nodes and Spleen. Washington, DC: Armed Forces Institute of Pathology; 1994.

    Google Scholar 

Lymphoid Hyperplasia

  • Abbondanzo SL, Irey NS, Frizzera G. Dilantin-associated lymphadenopathy: spectrum of histopathologic patterns. Am J Surg Pathol. 1995;19:675–86.

    Article  Google Scholar 

  • Campbell JAH. Cat-scratch disease. Pathol Annu. 1977;12:277–92.

    PubMed  Google Scholar 

  • Childs CC, Parham DM, Berard CW. Infectious mononucleosis: the spectrum of morphologic changes simulating lymphoma in lymph nodes and tonsils. Am J Surg Pathol. 1987;11:122–32.

    Article  PubMed  CAS  Google Scholar 

  • Dorfman RF, Warnke R. Lymphadenopathy simulating the malignant lymphomas. Hum Pathol. 1974;5:519–49.

    Article  PubMed  CAS  Google Scholar 

  • Epstein JI, Ambinder RF, Kuhajda FP, Pearlman SH, Reuter VE, Mann RB. Localized herpes simplex lymphadenitis. Am J Clin Pathol. 1986;86:444–8.

    PubMed  CAS  Google Scholar 

  • Ewing EP, Chandler FW, Spira TJ, Brynes RK, Chan WC. Primary lymph node pathology in AIDS and AIDS-related lymphadenopathy. Arch Pathol Lab Med. 1985;109:977–81.

    PubMed  Google Scholar 

  • Frizzera G. Castleman’s disease and related disorders. Semin Diagn Pathol. 1988;5:346–64.

    PubMed  CAS  Google Scholar 

  • Hartsock RJ. Postvaccinial lymphadenitis: hyperplasia of lymphoid tissue that simulates malignant lymphomas. Cancer. 1968;21:632–49.

    Article  PubMed  CAS  Google Scholar 

  • Miller-Catchpole R, Variakojis D, Vardiman JW, Loew JM, Carter J. Cat scratch disease: identification of bacteria in seven cases of lymphadenitis. Am J Surg Pathol. 1986;10:276–81.

    Article  PubMed  CAS  Google Scholar 

  • Nosanchuk JS, Schnitzer B. Follicular hyperplasia in lymph nodes from patients with rheumatoid arthritis: a clinicopathologic study. Cancer. 1969;24:343–54.

    Article  Google Scholar 

  • Pinder SE, Colville A. Mycobacterial cervical lymphadenitis in children: can histological assessment help differentiate infections caused by non-tuberculous mycobacteria from Mycobacterium tuberculosis? Histopathology. 1993;22:59–64.

    Article  PubMed  CAS  Google Scholar 

  • Rushin JM, Riordan GP, Heaton RB, Sharpe RW, Cotelingam JD, Jaffe ES. Cytomegalovirus-infected cells express Leu-M1 antigen: a potential source of diagnostic error. Am J Pathol. 1990;136:989–95.

    PubMed Central  PubMed  CAS  Google Scholar 

  • Saltzstein SL, Ackerman LV. Lymphadenopathy induced by anticonvulsant drugs and mimicking clinically and pathologically malignant lymphomas. Cancer. 1959;12:164–82.

    Article  PubMed  CAS  Google Scholar 

  • Stanley MW, Frizzera G. Diagnostic specificity of histologic features in lymph node biopsy specimens from patients at risk for the acquired immunodeficiency syndrome. Hum Pathol. 1986;17:1231–9.

    Article  PubMed  CAS  Google Scholar 

  • Turner RR, Levine AM, Gill PS, Parker JW, Meyer PR. Progressive histopathologic abnormalities in the persistent generalized lymphadenopathy syndrome. Am J Surg Pathol. 1987;11:625–32.

    Article  PubMed  CAS  Google Scholar 

  • Wood GS, Garcia CF, Dorfman RF, Warnke RA. The immunohistology of follicle lysis in lymph node biopsies from homosexual men. Blood. 1985;66:1092–7.

    PubMed  CAS  Google Scholar 

Non-Hodgkin Lymphoma

  • Argatoff LH, Connors JM, Klasa RJ, Horsman DE, Gascoyne RD. Mantle cell lymphoma: a clinicopathologic study of 80 cases. Blood. 1997;89:2067–78.

    PubMed  CAS  Google Scholar 

  • Banks PM, Arseneau JC, Gralnick HR, Canellos GP, DeVita VT, Berard CW. American Burkitt’s lymphoma: a clinicopathologic study of 30 cases. Am J Med. 1975;58:322–9.

    Article  PubMed  CAS  Google Scholar 

  • Banks PM, Chan J, Cleary ML, et al. Mantle cell lymphoma: a proposal for unification of morphologic, immunologic, and molecular data. Am J Surg Pathol. 1992;16:637–40.

    Article  PubMed  CAS  Google Scholar 

  • Barcos MP, Lukes RJ. Malignant lymphoma of convoluted lymphocytes: a new entity of possible T-cell type. In: Sinks LF, Godden JO, editors. Conflicts in childhood cancer: an evaluation of current management, vol. 4. New York: Liss; 1975. p. 147–78.

    Google Scholar 

  • Ben-Ezra J, Burke JS, Swartz WG, et al. Small lymphocytic lymphoma: a clinicopathologic analysis of 268 cases. Blood. 1989;73:579–87.

    PubMed  CAS  Google Scholar 

  • Broder S, Bunn PA, Jaffe ES, et al. T-cell lymphoproliferative syndrome associated with human T-cell leukemia/lymphoma virus. Ann Intern Med. 1984;100:543–57.

    Article  PubMed  CAS  Google Scholar 

  • Chan JKC, Ng CS, Lau WH, Lo STH. Most nasal/nasopharyngeal lymphomas are peripheral T-cell neoplasms. Am J Surg Pathol. 1987;16:418–29.

    Article  Google Scholar 

  • Chan JKC, Sin VC, Wong KF, et al. Nonnasal lymphoma expressing the natural killer cell marker CD56: a clinicopathologic study of 49 cases of an uncommon aggressive neoplasm. Blood. 1997;89:4501–13.

    PubMed  CAS  Google Scholar 

  • Chott A, Augustin I, Wrba F, Hanak H, Ohlinger W, Radaszkiewicz T. Peripheral T-cell lymphomas: a clinicopathologic study of 75 cases. Hum Pathol. 1990;21:1117–25.

    Article  PubMed  CAS  Google Scholar 

  • Chott A, Dragosics B, Radaskiesicz T. Peripheral T-cell lymphomas of the intestine. Am J Pathol. 1992;141:1361–71.

    PubMed Central  PubMed  CAS  Google Scholar 

  • Colby TV, Burke JS, Hoppe RT. Lymph node biopsy in mycosis fungoides. Cancer. 1981;47:351–9.

    Article  PubMed  CAS  Google Scholar 

  • Davis RE, Dorfman RF, Warnke RA. Primary large-cell lymphoma of the thymus: a diffuse B-cell neoplasm presenting as primary mediastinal lymphoma. Hum Pathol. 1990;21:1262–8.

    Article  PubMed  CAS  Google Scholar 

  • Delabie F, Vandenberghe E, Kennes C, et al. Histiocyte-rich B-cell lymphoma: a distinct clinicopathologic entity possibly related to lymphocyte predominant Hodgkin’s disease, paragranuloma subtype. Am J Surg Pathol. 1992;16:37–48.

    Article  PubMed  CAS  Google Scholar 

  • De Bruin PC, Kummer A, van der Valk P, et al. Granzyme B-expressing peripheral T-cell lymphomas: neoplastic equivalents of activated cytotoxic T cells with preference for mucosa-associated lymphoid tissue localization. Blood. 1994;84:3785–91.

    PubMed  Google Scholar 

  • Domizio P, Owen RA, Sheperd NA, et al. Primary lymphoma of the small intestine: a clinicopathologic study of 119 cases. Am J Surg Pathol. 1993;17:429–42.

    Article  PubMed  CAS  Google Scholar 

  • Dick FR, Maca RD. The lymph node in chronic lymphocytic leukemia. Cancer. 1978;41:283–92.

    Article  PubMed  CAS  Google Scholar 

  • Dohner H, Stilgenbauer S, Benner A, et al. Genomic aberrations and survival in chronic lymphocytic leukemia. N Engl J Med. 2000;343:1910–6.

    Article  PubMed  CAS  Google Scholar 

  • Ellison DJ, Nathwani BN, Cho SY, Martin SE. Interfollicular small lymphocytic lymphoma: the diagnostic significance of pseudofollicles. Hum Pathol. 1989;20:1108–18.

    Article  PubMed  CAS  Google Scholar 

  • Farcet J-P, Gaulard P, Marolleau J-P, et al. Hepatosplenic T-cell lymphoma: sinusal/sinusoidal localization of malignant cells expressing the T-cell receptor γδ. Blood. 1990;75:2213–9.

    PubMed  CAS  Google Scholar 

  • Feller AC, Griesser GH, Mak TW, Lennert K. Lymphoepithelioid lymphoma (Lennert’s lymphoma) is a monoclonal proliferation of helper/inducer T-cells. Blood. 1986a;68:663–7.

    PubMed  CAS  Google Scholar 

  • Feller AC, Parwaresch MR, Stein H, Ziegler A, Herbst H, Lennert K. Immunophenotyping of T-lymphoblastic lymphoma/leukemia: a correlation with normal T-cell maturation. Leuk Res. 1986b;10:1025–31.

    Article  PubMed  CAS  Google Scholar 

  • Gaulard P, d’Agay M-F, Peuchmaur M, et al. Expression of the bcl-2 gene product in follicular lymphoma. Am J Pathol. 1992;140:1089–95.

    PubMed Central  PubMed  CAS  Google Scholar 

  • Hamilton-Dutoit SJ, Raphael M, Audouin J, et al. In situ demonstration of Epstein-Barr virus small RNAs (EBER1) in acquired immunodeficiency syndrome-related lymphomas: correlation with tumor morphology and primary site. Blood. 1993;82:619–24.

    PubMed  CAS  Google Scholar 

  • Hammer RD, Glick AD, Greer JP, Collins RD, Cousar JB. Splenic marginal zone lymphoma: a distinct B-cell neoplasm. Am J Surg Pathol. 1996;20:613–26.

    Article  PubMed  CAS  Google Scholar 

  • Ioachim HL, Dorsett B, Dronin W, Maya M, Wahl S. Acquired immunodeficiency syndrome-associated lymphomas: clinical, pathologic, immunologic, and viral characteristics of 111 cases. Hum Pathol. 1991;22:659–73.

    Article  PubMed  CAS  Google Scholar 

  • Jaffe ES, Blattner WA, Blayley DW, et al. The pathologic spectrum of adult T-cell leukemia/ lymphoma in the United States: human T-cell leukemia/lymphoma virus-associated lymphoid malignancies. Am J Surg Pathol. 1984;8:263–75.

    Article  PubMed  CAS  Google Scholar 

  • Jaffe ES, Chan JKC, Su I-J, et al. Report of the workshop on nasal and related extranodal angiocentric T/natural killer cell lymphomas: definitions, differential diagnosis, and epidemiology. Am J Surg Pathol. 1996;20:103–11.

    Article  PubMed  CAS  Google Scholar 

  • Kanavaros P, Lescs M-C, Briere J, et al. Nasal T-cell lymphoma: a clinicopathologic entity associated with peculiar phenotype and with Epstein-Barr virus. Blood. 1993;81:2688–95.

    PubMed  CAS  Google Scholar 

  • Kirn D, Mauch P, Shaffer K, et al. Large-cell and immunoblastic lymphoma of the mediastinum: prognostic features and treatment outcome in 57 patients. J Clin Oncol. 1993;11:1336–43.

    PubMed  CAS  Google Scholar 

  • Knowles DM. Etiology and pathogenesis of AIDS-related non-Hodgkin’s lymphoma. Hematol Oncol Clin North Am. 1996;10:1081–109.

    Article  PubMed  CAS  Google Scholar 

  • Knowles DM, Chamulak GA, Subar M, et al. Lymphoid neoplasia associated with the acquired immunodeficiency syndrome (AIDS): the New York University Medical Center experience with 105 patients (1981–1986). Ann Intern Med. 1988;108:744–53.

    Article  PubMed  CAS  Google Scholar 

  • Lowenthal DA, Straus DJ, Campbell SW, Gold JWM, Clarkson BD, Koziner B. AIDS-related lymphoid neoplasia: the Memorial Hospital experience. Cancer. 1988;61:2325–37.

    Article  PubMed  CAS  Google Scholar 

  • Macon WR, Williams ME, Greer JP, Stein RS, Collins RD, Cousar JB. T-cell-rich B-cell lymphomas: a clinicopathologic study of 19 cases. Am J Surg Pathol. 1992;16:351–63.

    Article  PubMed  CAS  Google Scholar 

  • Martin AR, Weisenburger DD, Chan WC, et al. Prognostic value of cellular proliferation and histologic grade in follicular lymphoma. Blood. 1995;85:3671–8.

    PubMed  CAS  Google Scholar 

  • Mollejo M, Menarguez J, Lloret E, et al. Splenic marginal zone lymphoma: a distinctive type of low-grade B-cell lymphoma. Am J Surg Pathol. 1995;19:1146–57.

    Article  PubMed  CAS  Google Scholar 

  • Nathwani BN, Kim H, Rappaport H. Malignant lymphoma, lymphoblastic. Cancer. 1976;38:964–83.

    Article  PubMed  CAS  Google Scholar 

  • Nathwani BN, Metter GE, Miller TP, et al. What should be the morphologic criteria for the subdivision of follicular lymphomas? Blood. 1986;68:837–45.

    PubMed  CAS  Google Scholar 

  • Nathwani BN, et al. Malignant lymphoma arising in angioimmunoblastic lymphadenopathy. Cancer. 1978;41:578–606.

    Article  PubMed  CAS  Google Scholar 

  • Ng CS, Chan JKC, Hui PK, Lau WH. Large B-cell lymphomas with a high content of reactive T cells. Hum Pathol. 1989;20:1145–54.

    Article  PubMed  CAS  Google Scholar 

  • Patsouris I, Noel H, Lennert K. Histological and immunohistological findings in lymphoepithelioid cell lymphoma (Lennert’s lymphoma). Am J Surg Pathol. 1988;12:341–50.

    Article  PubMed  CAS  Google Scholar 

  • Patsouris E, Noel H, Lennert K. Angioimmunoblastic lymphadenopathy-type of T-cell lymphoma with a high content of epithelioid cells. Am J Surg Pathol. 1989;13:262–75.

    Article  PubMed  CAS  Google Scholar 

  • Perrone T, Frizzera G, Rosai J. Mediastinal diffuse large-cell lymphoma with sclerosis: a clinicopathologic study of 60 cases. Am J Surg Pathol. 1986;10:176–91.

    Article  PubMed  CAS  Google Scholar 

  • Pinkus GS, O’Hara CJ, Said JW. Peripheral/post-thymic T-cell lymphomas: a spectrum of disease. Clinical, pathologic and immunologic features of 78 cases. Cancer. 1990;65:971–98.

    Article  PubMed  CAS  Google Scholar 

  • Pittaluga S, Verhoef F, Driel A, et al. “Small” B-cell non-Hodgkin’s lymphomas with splenomegaly at presentation are either mantle cell lymphoma or marginal zone cell lymphoma: a study based on histology, cytology, immunohistochemistry, and cytogenetic analysis. Am J Surg Pathol. 1996;20:211–23.

    Article  PubMed  CAS  Google Scholar 

  • Raphael MM, Audouin J, Lamine M, et al. Immunophenotypic and genotypic analysis of acquired immunodeficiency syndrome-related Non-Hodgkin’s lymphomas: correlation with histologic features in 36 cases. Am J Clin Pathol. 1994;101:773–82.

    PubMed  CAS  Google Scholar 

  • Rappaport H, Thomas LB. Mycosis fungoides: the pathology of extracutaneous involvement. Cancer. 1974;34:1198–229.

    Article  PubMed  CAS  Google Scholar 

  • Rosenberg SA, Berard CW, Brown BW, et al. National Cancer Institute sponsored study of classifications of non-Hodgkin’s lymphomas: summary and description of a working formulation for clinical usage. Cancer. 1982;49:2112–35.

    Article  Google Scholar 

  • Sausville EA, Worsham GF, Matthews MJ, et al. Histologic assessment of lymph nodes in mycosis fungoides/Sezary syndrome (cutaneous T-cell lymphoma): clinical correlations and prognostic import of a new classification system. Hum Pathol. 1985;16:1098–109.

    Article  PubMed  CAS  Google Scholar 

  • Shimoyama M, et al. Diagnostic criteria and classification of clinical subtypes of adult T-cell leukaemia-lymphoma: a report from the Lymphoma Study Group (1984–87). Br J Haematol. 1991;79:428–37.

    Article  PubMed  CAS  Google Scholar 

  • Shivdasani RA, Hess JL, Skarin AT, Pinkus GS. Intermediate lymphocytic lymphoma: clinical and pathologic features of a recently characterized subtype of non-Hodgkin’s lymphoma. J Clin Oncol. 1993;11:802–11.

    PubMed  CAS  Google Scholar 

  • Tobinac K, et al. Clinicopathologic and immunophenotypic analyses of immunoblastic lymphadenopathy-like T-cell lymphoma. Blood. 1988;72:1000–6.

    Google Scholar 

  • Variakojis D, Rosas-Uribe A, Rappaport H. Mycosis fungoides: pathologic findings in staging laparotomies. Cancer. 1974;33:1589–600.

    Article  PubMed  CAS  Google Scholar 

  • Weiss LM, Bindl JM, Picozzi VJ, Link MP, Warnke RA. Lymphoblastic lymphoma: an immunophenotype study of 26 cases with comparison to T cell acute lymphoblastic leukemia. Blood. 1986a;67:474–8.

    PubMed  CAS  Google Scholar 

  • Weiss JW, Winter MW, Phyliky RL, Banks PM. Peripheral T-cell lymphomas: histologic, immunohistologic and clinical characterization. Mayo Clin Proc. 1986b;61:411–26.

    Article  Google Scholar 

Hodgkin Lymphoma

  • Lukes RJ. Criteria for involvement of lymph node, bone marrow, spleen, and liver in Hodgkin’s disease. Cancer Research. 1971;31:1755–67.

    PubMed  CAS  Google Scholar 

  • Poppema S. Lymphocyte-predominance Hodgkin’s disease. Int Rev Exp Pathol. 1992;33:53–79.

    Article  PubMed  CAS  Google Scholar 

  • von Wasielski R, Werner M, Fischer R, et al. Lymphocyte-predominance Hodgkin’s disease. An immunohistochemical analysis of 208 reviewed Hodgkin’s disease cases from the German Hodgkin’s Study Group. Am J Pathol. 1997;150:793–803.

    Google Scholar 

  • von Wasielewski R, Mengel M, Fischer R, et al. Classical Hodgkin’s disease. Clinical impact of the immunophenotype. Am J Pathol. 1997;151: 1123–30.

    Google Scholar 

Histiocytic Lymph Node Tumors

  • Foucar E, Rosai J, Dorfman R. Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): review of the entity. Semin Diagn Pathol. 1990;7:19–73.

    PubMed  CAS  Google Scholar 

  • Motoi M, Helbron D, Kaiserling E, Lennert K. Eosinophilic granuloma of lymph nodes – a variant of histiocytosis X. Histopathology. 1980;4: 585–606.

    Article  PubMed  CAS  Google Scholar 

Spindle Cell Lesions of Lymph Node

  • Chan JKC, Lewin KJ, Lombard CM, Teitelbaum S, Dorfman RF. Histopathology of bacillary angiomatosis of lymph node. Am J Surg Pathol. 1991;15:430–7.

    Article  PubMed  CAS  Google Scholar 

  • Moran CA, Suster S, Abbondanzo SL. Inflammatory pseudotumor of lymph nodes: a study of 25 cases with emphasis on morphologic heterogeneity. Hum Pathol. 1997;28:332–8.

    Article  PubMed  CAS  Google Scholar 

  • Perrone T, De Wolf-Peeters C, Frizzera G. Inflammatory pseudotumor of lymph nodes: a distinctive pattern of nodal reaction. Am J Surg Pathol. 1988;12:351–61.

    Article  PubMed  CAS  Google Scholar 

  • Weiss SW, Gnepp DR, Bratthauer GL. Palisaded myofibroblastoma: a benign mesenchymal tumor of lymph node. Am J Surg Pathol. 1989;13: 341–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA

    Ellen D. McPhail MD & Paul J. Kurtin MD

Authors
  1. Ellen D. McPhail MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul J. Kurtin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ellen D. McPhail MD .

Editor information

Editors and Affiliations

  1. Indiana University School of Medicine, Indianapolis, Indiana, USA

    Liang Cheng

  2. Granger Diagnostics, A Division of Granger Genetics, North Chesterfield, Virginia, USA

    David G. Bostwick

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

McPhail, E.D., Kurtin, P.J. (2016). Lymph Node. In: Cheng, L., Bostwick, D. (eds) Essentials of Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-23380-2_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-23380-2_15

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-23379-6

  • Online ISBN: 978-3-319-23380-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation