Angiofollicular lymph node hyperplasia (Castleman).
Six personally observed cases of this lesion are reported and the literature is reviewed. One hundred and thirty-four cases have been reported to date. The lesion has occurred in many sites, but is commonest in the thorax (60%), abdomen (11%), neck (14%), and axilla (4%). Ninety per cent of cases are symptomless or have only the pressure symptoms, 10% have systemic signs, namely, fever, raised ESR, anaemia, cured by removal of the tumour. These cases have a slightly different histology. All recorded cases have been benign. Microscopically the lesion is follicular but instead of germinal centres the follicles have one or more thick-walled arteries and often some surrounding histiocytes. Increased numbers of vessels occur between the follicles, whilst sinuses are absent. These vessels have thick, cellular walls like post-capillary venules. Sometimes they become hyaline. The cases with symptoms have true reaction centres as well as a few intrafollicular vessels. Between the follicles there are increased numbers of vessels and, in addition, there may be collections of plasma cells or eosinophils.
D000328:Adult; D000740:Anemia / Q000150:complications; D001158:Arteries / Q000473:pathology; D001799:Blood Sedimentation; D004804:Eosinophils; D005260:Female; D005334:Fever / Q000150:complications; D006644:Histiocytes; D006801:Humans; D006965:Hyperplasia / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D008198:Lymph Nodes; D008297:Male; D008477:Mediastinal Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D010950:Plasma Cells; D011312:Pressure