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Reaktive Lymphadenopathien

Reactive lymphadenopathies

  • Schwerpunkt: Nichtneoplastische Hämatopathologie
  • Published:
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Zusammenfassung

Die ca. 600 Lymphknoten des Menschen sind Bestandteil des dezentralen Immunsystems. Die wesentlichen Aufgaben der Lymphknoten bestehen in der Reinigung der Lymphe und der Verteidigung des Gesamtorganismus gegenüber äußeren und inneren Bedrohungen durch Bakterien, Viren und Tumorzellen. Die Histologie der Lymphknoten spiegelt unterschiedliche Strategien des B‑ und T‑Zellsystems, der antigenpräsentierenden Zellen, Makrophagen und Retikulumzellen wider. Dennoch lässt die Kenntnis des histologischen Bildes ohne ergänzende Untersuchungen bisher meist nur Vermutungen auf das auslösende Agens wie Toxoplasmose, Bakterien und Viren zu. In diesem Kapitel wird auf die Beschreibung unterschiedlicher Lymphknoten-Reaktionsformen eingegangen, um zu einem besseren Verständnis von Immunreaktionen und der Abgrenzung zu bösartigen immunologischen Prozessen zu gelangen. Gerade letzteres zählt zu einer der wichtigsten Aufgaben der Hämatopathologie und ist Basis für ergänzende molekularpathologische Untersuchungen. Zusätzlich zu diesen bekannten Prinzipien versuchen wir eine neue Methodik und Sichtweise, die dreidimensionale (3D) Untersuchung von fixiertem Lymphknotengewebe, in das Lymphadenitis-Kapitel zu integrieren. Dies mag zunächst ungewöhnlich erscheinen. Der Versuch wird dennoch unternommen, da die 3D-Darstellung morphologische Details erkennen lässt, die neue Interpretationen von Zellinteraktionen, Abgrenzung und Funktionen von Lymphknotenkompartimenten wie Keimzentren und T‑Zonen ermöglicht.

Abstract

The human body comprises around 600 lymph nodes as constituents of a decentralized and dispersed immune system. The main task of lymph nodes is cleaning the lymph fluid and defending the organism against outer and inner threats by bacteria, viruses and tumour cells. The histologic picture of lymph nodes reflects the different strategies of the innate and adaptive immune system, which allocates antigen presenting cells, macrophages, B‑ and T‑cell systems and reticulum cells. However, the histological picture, without any additional investigations, usually only allows speculation about the causative agent like toxoplasmosis, other bacteria or viruses. This chapter describes different lymph node reactions in detail in order to obtain a better understanding of specific immune reactions allowing a precise diagnosis and a reliable distinction from malignant processes. The last issue in particular is one of the main tasks of haematopathology. In addition to these known principles, we try to integrate results obtained with the new method of three-dimensional (3D) microscopy of fixed lymphoid tissue. At first glance, this seems to be unusual. Nevertheless, we try to apply this approach, since 3D visualization of morphological details provides distinct cellular details as well as new interpretations of cell–cell interactions and the functions of lymphoid compartments, like germinal centres and T‑zones.

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Authors and Affiliations

  1. Dr. Senckenbergisches Institut für Pathologie, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland

    Sylvia Hartmann

  2. Konsultationszentrum für Hämatopathologie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland

    Martin-Leo Hansmann

  3. Frankfurt Institute for Advanced Studies, Ruth-Moufang-Str. 1, 60438, Frankfurt am Main, Deutschland

    Martin-Leo Hansmann

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  1. Sylvia Hartmann
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Correspondence to Sylvia Hartmann.

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Interessenkonflikt

S. Hartmann und M.-L. Hansmann geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Schwerpunktherausgeber

F. Fend, Tübingen

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Hartmann, S., Hansmann, ML. Reaktive Lymphadenopathien. Pathologie 43, 271–281 (2022). https://doi.org/10.1007/s00292-022-01075-3

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  • DOI: https://doi.org/10.1007/s00292-022-01075-3

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