title: Clinical implication of florid reactive follicular hyperplasia in Japanese patients 60 years or older: a study of 46 cases.
abstract: Florid reactive follicular hyperplasia (FRFH) of the enlarged lymph node in middle-aged or elderly patients requiring biopsy is a relatively uncommon phenomenon as compared with that in younger age groups. Between 1984 and January 2004, we encountered 46 patients, aged 60 years or older, in whom histology of biopsied lymph node specimens showed inappropriate FRFH for the patient's age. An apparent cause of lymphadenopathy was initially identified in 17 cases (37%): 11 with autoimmune disease and related disorders, 3 with cancer-reactive lymphadenopathy, 2 with Epstein-Barr virus-associated lymph node lesion exhibiting transient autoimmune-disease-like clinical findings, and 1 with atypical mycobacterial infection. Among 29 patients without specific etiology, 16 patients (55%) exhibited histologic findings of progressive transformed germinal center (PTGC). Only 1 of our patients developed malignant lymphoma during the follow-up period. The present study indicates that PTGC is included in the etiology of FRFH in elderly Japanese patients as well as imbalance of the immune system such as autoimmune-disease-associated lymphadenopathy and idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia. By in situ hybridization, Epstein-Barr virus genomes were demonstrated in only 6 (15%) of 39 cases examined.
authors.affiliation: Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Kojima
authors.forename: Shigeo
authors.initials: S
authors.lastname: Nakamura
authors.forename: Hideaki
authors.initials: H
authors.lastname: Itoh
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Shimizu
authors.forename: Kayoko
authors.initials: K
authors.lastname: Murayama
authors.forename: Misa
authors.initials: M
authors.lastname: Iijima
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hosomura
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ohno
authors.forename: Katsue
authors.initials: K
authors.lastname: Yoshida
authors.forename: Tadashi
authors.initials: T
authors.lastname: Motoori
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Sakata
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Masawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000150:complications / Q000473:pathology; D001706:Biopsy; D005260:Female; D018858:Germinal Center / Q000473:pathology*; D006566:Herpesviridae Infections / Q000150:complications / Q000473:pathology; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D008206:Lymphatic Diseases / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000473:pathology; D019310:Pseudolymphoma / Q000209:etiology / Q000473:pathology*