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Follicular Hyperplasia (Low Power)
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Follicular Hyperplasia (Low Power)

A very low power view of a lymph node manifesting follicular hyperplasia.
In a normal lymph node, lymph follicles are usually distributed just beneath the capsule.
In this particular lesion, you will notice germinal centers far down in the medullary region.
Note as well, the pronounced differences in the sizes of the germinal centers of these follicles.
Some of the germinal center, particularly those that lie under the capsule (left top corner) are significantly enlarged.
(Description By:T. V. Rajan, M.D. )
(Image Contrib. by:T.V.Rajan, M.D. UCHC )
Follicular hyperplasia
Etiology

Lymph nodes react to inflammatory processes in the area they drain.
Any infectious agent, including bacterial, viral, rickettsial, protozoan, parasitic and chlamydial pathogens can cause follicular hyperplasia.
Pathogenesis

The offending organism is brought into the lymph node by lymphatic drainage, and is phagocytosed and degraded within macrophages in the lymph nodes, initiating an immune reaction.
The resulting proliferation of T and B lymphocytes and increased blood flow increases mass of the lymph node, manifesting as enlargement of the lymph node and tenderness.,
Epidemiology

Extremely common in all age groups and both sexes.
General Gross Description

Grossly, the lymph node is tense, enlarged 2-3 times the normal size.
On section, the cells tend to bulge above the cut surface.
Individual enlarged germinal centers may be visualized as small grainy prominences.
General Microscopic Description

Microscopically, the follicles are significantly enlarged over the normal size.
Particularly prominent are the germinal centers, where multiple mitotic figures and active proliferation of cells may be seen.
In addition, large histiocytic cells with debris within them may be seen.
Clinical Correlation

Follicular hyperplasia manifests as enlargement and tenderness of the affected node(s).
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 632
Follicular hyperplasia
Synopsis by: T.V.Rajan, M.D., Ph.D. (T08000M72000)[594]
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