title: Lymph node pathology in patients with a clinical diagnosis of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD): an analysis of 37 cases.
abstract: Lymph node pathology was analyzed in 37 patients clinically diagnosed as having angioimmunoblastic lymphadenopathy with dysproteinemia (AILD). Results confirmed AILD in 11 cases and were compatible with AILD in 2 cases. Reactive lymphoid hyperplasia was found in 15 cases, 2 cases had angiofollicular lymphoid hyperplasia or Castleman's disease, atypical lymphoid hyperplasia suggestive of malignant lymphoma was observed in 3 cases, and malignant lymphoma was diagnosed in the remaining 4 cases. The histopathologic features of AILD which differed from reactive lymphoid hyperplasia were effacement of lymph node architecture, vascular arborization, high endothelial venules, and capsular infiltration (p-value < 0.05). Lymphodepletion and PAS-positive interstitial material were occasionally found in both groups (p-value > 0.05). Among the 15 cases with pathology of reactive lymphoid hyperplasia, we identified 8 cases with hyperplastic lymphoid follicles, interfollicular plasmacytosis and hypervascularity which we designated as a hyperimmune reaction. This study emphasizes the necessity of lymph node examination in all patients with a clinical suspicion of AILD.
authors.affiliation: Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Upara
authors.forename: T
authors.initials: T
authors.lastname: Ruchutrakool
authors.forename: S
authors.initials: S
authors.lastname: Sukpanichnant
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000175:diagnosis / Q000276:immunology / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged