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Cited by 169Lymphadenopathy Diagnosis and AnalysisSarcoidosis and Beryllium Toxicity ResearchTuberculosis Research and Epidemiology

Granulomatous Lymphadenitis

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Asano, Shigeyuki·2012·Journal of Clinical and Experimental Hematopathology
DOI 10.3960/jslrt.52.1
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Abstract

In this review, representative types of granulomatous lymphadenitis (GLA) are described. GLA can be classified as noninfectious GLA and infectious GLA. Noninfectious GLA includes sarcoidosis and sarcoid-like reaction. The cause of sarcoidosis remains unknown, but it has good prognosis. Sarcoid-like reaction, which is considered to be a biological defense mechanism, is observed in regional lymph nodes with many underlying diseases. Infectious GLA can be classified as suppurative lymphadenitis (LA) and nonsuppurative LA. Suppurative LA generally shows follicular hyperplasia and sinus histiocytosis in the early phase. In tularemia and cat scratch disease, monocytoid B lymphocytes (MBLs) with T cells and macrophages contribute to the formation of granuloma. However, none of the epithelioid cell granulomas of Yersinia LA contains MBLs like in cat scratch disease. In addition, almost all have a central abscess in granulomas induced by Gram-negative bacteria. In terms of the lymph nodes, tularemia and cat scratch disease are apt to affect the axillary and cervical regions while Yersinia LA affects the mesenteric lymph node. Nonsuppurative LA includes tuberculosis and BCG-histiocytosis. These are induced by delayed allergic reaction of M. tuberculosis. Tuberculosis LA mainly appears in the cervical lymph node. Organisms are histologically detected by Ziehl-Neelsen staining in the necrotic area. Toxoplasmosis is also a nonsuppurative protozoan infection (Toxoplasma gondii). In toxoplasma LA, MBLs can also be seen, but round and organized, well-formed granulomas are not found in this disease. Furthermore, necrosis is not induced and there are no accompanying neutrophils, eosinophils and fibrosis. GLA described above is associated with characteristic histological findings. An accurate pathological diagnosis using the above findings can lead to precise treatment.

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  • Even in the presence of granulomatous inflammation, it can be difficult to differentiate TB from other diseases causing granulomas on FNAC, such as sarcoidosis, leprosy and fungal infections.

    “Even in the presence of granulomatous inflammation, it can be difficult to differentiate TB from other diseases causing granulomas on FNAC, e.g., sarcoidosis, leprosy and fungal infections.28”

    From Significance of non‐granulomatous cytomorphology on fine needle aspirate in lymphadenitis cases classified as tuberculous by using a composite reference standard (2023) · cites this paper as [28]

    The Clinical Findings section says tuberculous lymphadenitis can sometimes be difficult to distinguish from other conditions, and discusses sarcoidosis and fungal infection in the differential diagnosis. It does not establish that differentiation from the listed diseases is difficult specifically on FNAC, and the cited passages do not address leprosy; indeed, the section says sarcoid granulomas can usually be distinguished from those of tuberculosis and fungal infection. Page numbers are unavailable in our copy. (LLM, conf=0.78)

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Research works printed but not linked: 7

  1. Chang KL, Arber DA, Gaal KK, Weiss LM: Lymph nodes and spleen. In : Silverberg SG, DeLellis RA, Frable WJ, Livolsi VA, Wick MR (eds) : Silverberg's principles and practice of surgical pathology and cytopathology. 4th ed, Philadelphia, Churchill LivingStone, pp.508-607, 2006
  2. Ioachim HL, Medeiros LJ: Sarcoidosis Lymphadenopathy. In : Ioachim HL, Medeiros LJ (eds) : Ioachim's Lymph node pathol- ogy. 4th ed, Philadelphia, Lippincott Williams & Wilkins, pp. 203-212, 2009
  3. Ioachim HL, Medeiros LJ: Cat-scratch Lymphadenopathy. In : Ioachim HL, Medeiros LJ (eds) : Ioachim's Lymph node pathol- ogy. 4th ed, Philadelphia, Lippincott Williams & Wilkins, pp. 110-114, 2009
  4. Samuelson J, von Lichtenberg F: Infectious disease. In : Cotran RS, Kumar V, Robbins SL (eds) : Pathologic basis of disease, 5th ed, Philadelphia, W. B. Saunders, pp.305-377, 1994 76
  5. Ioachim HL: Granulomatous lesions of lymph nodes. In : Ioachim HL (ed) : Pathology of granulomas. New York, Raven Press, pp.151-187, 1983
  6. Symmers W St C: Lymphadenitis following injection of bacillus Calmette-Guérin. Systemic pathology. 5th ed, Edinburgh, Churchil Livingstone, pp.370-371, 1992
  7. Ioachim HL, Medeiros LJ: Toxoplasma Lymphadenitis. In : Ioachim HL, Medeiros LJ (eds) : Ioachim's Lymph node pathol- ogy. 4th ed, Philadelphia, Lippincott Williams & Wilkins, pp. 159-164, 2009

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Authors
Asano, S.
Affiliations
Iwaki Kyoritsu General Hospital (JP)
Corresponding author
Asano, Shigeyuki
Venue
Journal of Clinical and Experimental Hematopathology
Publisher
Japanese Society for Lymphoreticular Tissue Research
Published
2012
Volume
52
Issue
1
Pages
1-16
ISSN
  • 0386-9725 (ISSN-L)
  • 1346-4280
  • 1880-9952
DOI
10.3960/jslrt.52.1
OpenAlex
W4234307882
Cited by
169
References
59
Citations by year
2026: 8 · 2025: 11 · 2024: 11 · 2023: 7 · 2022: 11 · 2021: 17 · 2020: 16 · 2019: 10 · 2018: 23 · 2017: 14 · 2016: 13 · 2015: 12 · 2014: 7 · 2013: 7 · 2012: 1
FWCI
1.67
Type
journal article
Language
en
Open access
Locations
  • Journal of the Japan Society of the Reticuloendothelial System (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Lymphadenopathy Diagnosis and Analysis
  • Health Sciences › Medicine › Physiology › Sarcoidosis and Beryllium Toxicity Research
  • Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
Keywords
granulomatous lymphadenitis, sarcoidosis, sarcoid-like reaction, suppurative lymphadenitis, tularemia, cat scratch disease, tuberculosis, toxoplasmosis, granuloma, lymph node histopathology, Ziehl-Neelsen staining
MeSH terms
Animals, Cat-Scratch Disease, Granuloma, Humans, Lymph Nodes, Sarcoidosis, Gram-Negative Bacterial Infections

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