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Simple Summary: This study of the gastric mucosa biopsies of 41 dogs highlighted the endoscopic, histopathological, and immunohistochemical findings of gastric lymphofollicular hyperplasia (GLFH), emphasizing its frequent occurrence in young French Bulldogs (75.06%). GLFH was associated with glandular atrophy, lymphoplasmacytic inflammation, fibrosis, and varying degrees of Helicobacter-like organisms (HLOs) colonization. Immunohistochemistry showed positive Bcl6 and Pax5 B lymphocytes within the germinative center of large follicles, surrounded by CD3+ T lymphocytes, consistent with hyperplastic changes. A significant correlation was observed between the follicle diameter and HLO colonization (p = 0.049) and follicular hyperplasia severity (p < 0.001). These findings contribute to the pathogenesis of GLFH in dogs and underscore the need for further studies on its potential progression to cancer. Gastric lymphofollicular hyperplasia (GLFH) is characterized by large lymphoid nodules in the lamina propria. Its etiology and immunohistochemical characteristics are poorly understood. This study analyzed 41 canine GLFH cases, including clinical, endoscopic, histopathological, and immunohistochemical evaluations. Young French Bulldogs (75.06%) were the most affected. Endoscopically, lymphoid nodules were identified in both the antrum and gastric body. Lymphoid follicle diameters were similar in the gastric body (mean 295.587 μm) and antrum (mean 294.641 μm). Associated lesions included glandular atrophy, lymphoplasmacytic inflammation, and fibrosis. Minimal, moderate, and severe colonization with Helicobacter-like organisms (HLOs) were observed in 20, 6, and 3 cases, respectively. B-cell lymphocytes positive for Bcl6 and Pax5 were localized centrally in large follicles, surrounded by CD3+ T lymphocytes. Small follicles lacked germinal centers and showed mixed T and B lymphocytes. A positive correlation was found between the follicle diameter and both HLOs colonization (p = 0.049) and follicular hyperplasia (p < 0.001). A regression analysis indicated that HLOs colonization and hyperplasia accounted for 42.3% of follicle diameter variance (R2 = 0.423, p < 0.001). Additional studies are required to investigate potential correlations between GLFH and HLOs, as well as to assess the role of this lesion in the progression to neoplasia. [ABSTRACT FROM AUTHOR]

Background: Primary cutaneous marginal zone lymphoma (PCMZL) and primary cutaneous CD4+ small/medium T‐cell lymphoproliferative disease (CD4+ TLPD) are two distinct entities with excellent prognosis; however, they show profound clinical and histopathological similarities, leading to differential diagnostic uncertainty. Aims: Our aim was to review and reanalyze cases of primary cutaneous lymphoproliferations diagnosed at Semmelweis University, featuring characteristics of PCMZL and CD4+ TLPD. Materials and Methods: Cutaneous lymphoma biopsy specimens between 2018 and 2022 were collected and re‐evaluated. Medical history, clinical picture, imaging, and laboratory findings were collected. Immunohistochemical staining for CD20, CD3, BCL6, CD10, PD1, CD3, CD4, CD8, and PCR tests for IGH, IGK, TCRB, and TCRG were repeated in selected cases. Results: Among 55 cases diagnosed as PCMZL (16) or CD4+ TLPD (39), 3 patients had been diagnosed with both LPDs at different time points of their disease course. Four additional patients were identified with single lesions featuring overlapping histopathological characteristics of both LPDs and both monoclonal IGH and TCR rearrangements. All patients are currently in complete remission with local treatment. Conclusion: We propose that besides the overlapping histopathological, molecular, and clinical features, the subsequent appearance of PCMZL and CD4+ TLPD in a short timeframe in the same patients may suggest a common pathogenic background. [ABSTRACT FROM AUTHOR]

The article "Cytomegalovirus (CMV) Appendicitis in an Immunocompetent Child Masked by Prominent Lymphoid Hyperplasia" discusses a case of a 7-year-old male with no significant medical history who presented with symptoms of appendicitis. The patient underwent an uncomplicated laparoscopic appendectomy, and histologic examination revealed CMV infection masked by lymphoid hyperplasia. While CMV appendicitis is rare in immunocompetent individuals, this case underscores the importance of closely assessing appendix specimens for viral involvement, regardless of immune status. [Extracted from the article]

Purpose: Conjunctival lymphoid hyperplasia is a benign condition that typically presents with irritation, conjunctival injection, and eyelid edema. Topical corticosteroid drops are often the first-line treatment when not excised, but long-term use may cause intraocular pressure spikes or cataract formation. Steroid-sparing agents could be considered to manage patients who require long-term treatment. Here we discuss the potential benefit of topical tacrolimus use for the management of these patients. Observations: We present two cases of conjunctival lymphoid hyperplasia, one in a 74-year-old man and one in a 41-year-old woman. Both showed a positive response to topical steroid treatment, but due to intraocular pressure elevations, needed to be trialed on steroid-sparing medications. Topical tacrolimus (Protopic) at 0.03 % concentration was applied to the inferior fornix. Patients were monitored for improvement on exam and for subjective improvement of their symptoms. Topical tacrolimus produced moderate to complete resolution of the lesions in these patients and resulted in symptomatic improvement. Conclusions and importance: Tacrolimus is an immunomodulatory medication. The ointment form is approved for use in atopic dermatitis (eczema). Although it is an off-label use, it has been used for other ocular conditions with variable success and tolerability, but we did not find any prior reports of its use in conjunctival benign lymphoid hyperplasia.

Purpose: To investigate the role of magnetic resonance imaging (MRI) based on radiomics using T2-weighted imaging fat suppression (T2WI-FS) and contrast enhanced T1-weighted imaging (CE-T1WI) sequences in differentiating T1-category nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPH). Materials and methods: This study enrolled 614 patients (training dataset: n = 390, internal validation dataset: n = 98, and external validation dataset: n = 126) of T1-category NPC and NPH. Three feature selection methods were used, including analysis of variance, recursive feature elimination, and relief. The logistic regression classifier was performed to construct the radiomics signatures of T2WI-FS, CE-T1WI, and T2WI-FS + CE-T1WI to differentiate T1-category NPC from NPH. The performance of the optimal radiomics signature (T2WI-FS + CE-T1WI) was compared with those of three radiologists in the internal and external validation datasets. Results: Twelve, 15, and 15 radiomics features were selected from T2WI-FS, CE-T1WI, and T2WI-FS + CE-T1WI to develop the three radiomics signatures, respectively. The area under the curve (AUC) values for radiomics signatures of T2WI-FS + CE-T1WI and CE-T1WI were significantly higher than that of T2WI-FS (AUCs = 0.940, 0.935, and 0.905, respectively) for distinguishing T1-category NPC and NPH in the training dataset (Ps all < 0.05). In the internal and external validation datasets, the radiomics signatures based on T2WI-FS + CE-T1WI and CE-T1WI outperformed T2WI-FS with no significant difference (AUCs = 0.938, 0.925, and 0.874 for internal validation dataset and 0.932, 0.918, and 0.882 for external validation dataset; Ps > 0.05). The radiomics signature of T2WI-FS + CE-T1WI significantly performed better than three radiologists in the internal and external validation datasets. Conclusion: The MRI-based radiomics signature is meaningful in differentiating T1-category NPC from NPH and potentially helps clinicians select suitable therapy strategies. [ABSTRACT FROM AUTHOR]

Syphilis can mimic, clinically and microscopically, many other diseases. By microscopy, typically syphilis presents with plasma cell infiltration, admixed with lymphocytes and macrophages, in lichenoid and/or perivascular/perineural distribution pattern. When exuberant, this inflammatory infiltrate can mimic a lymphoproliferative disorder (LPD), notably plasma cell neoplasia or lymphoma. To date, about 12 cases of secondary syphilis, all but one in extraoral location, suggesting initially a LPD, have been published. Here, to our knowledge, we report an unusual case of intraoral primary syphilis initially suggesting LPD, notably lymphoid hyperplasia (pseudolymphoma); however, mucosa‐associated lymphoid tissue (MALT) lymphoma and follicular lymphoma could not be disregarded. Polyclonality of plasma cells on immunohistochemistry, in strict clinical correlation, was essential to arrive at the correct diagnosis. [ABSTRACT FROM AUTHOR]

Objective:Enterobius vermicularis is a common gastrointestinal parasite. Acute appendicitis is one of the most common clinical conditions requiring surgical intervention. The coexistence of enterobiasis and acute appendicitis has attracted the attention of researchers for a long time. In this article, it is aimed to present the characteristics of enterobiasis cases detected in appendectomy specimens in a tertiary healthcare institution. In addition, it is aimed to reveal the differences by comparing the cases diagnosed with acute appendicitis without enterobiasis.Methods:All cases operated for acute appendicitis between January 1, 2008 and December 31, 2021 were retrospectively evaluated through the hospital registry system. The cases with histopathologically determined E. vermicularis were reviewed and a study group was formed. The control group consisted of patients diagnosed with acute appendicitis for reasons other than enterobiasis, matched with the study group in terms of age and gender. Complete blood count, C-reactive protein (CRP) ultrasonography evaluations were compared between the two groups.Results:During the study period, 3.650 appendectomy materials were examined; E. vermicularis was detected in 1.32% (n=48) cases, and acute appendicitis was present in 33.33% (n=16) of the cases. Lymphoid hyperplasia was the most common histopathological change in the study group (n=25; 52.08%). When compared to the control group, leukocyte, neutrophil, CRP, ultrasonographic appendix diameter values were found to be significantly higher in the control group, and the percentage of eosinophils in the study group (p

Objective: This study aimed to assess the relationship between Enterobius vermicularis and appendicitis by determining the frequency of E. vermicularis in appendectomy specimens obtained after a preliminary diagnosis of appendicitis. Materials and Methods: Retrospective evaluation was conducted on the results of appendectomy specimens examined histopathologically at Van Training and Research Hospital Pathology Laboratory from March 2016 to March 2022. Hematoxylin-eosin stained slides from 7,814 appendectomy specimens were scrutinized for the presence of E. vermicularis, acute inflammation, fecaloid material, lymphoid hyperplasia, obliteration, perforation, phlegmonous appendicitis, and peritonitis. Furthermore, slides stained with hematoxylin-eosin (H&E) from patients testing positive for E. vermicularis were re-evaluated by the author in pathology. Results: E. vermicularis was identified in the appendectomy specimens of 50 (0.64%) out of 7,814 patients who underwent appendectomies. In histopathological examinations, the occurrence of lymphoid hyperplasia and fibrous obliteration was higher in E. vermicularis-positive patients compared to those who teste negative. Findings revealed that the mean white blood cell count (WBC) was lower in E. vermicularis-positive patients than in negative patients, while the mean eosinophil percentage (EO%) was higher. Conclusion: These findings imply that although the parasite is not a direct causative factor for appendicitis, it may contribute to the development of factors that result in obstruction in certain cases. [ABSTRACT FROM AUTHOR]

In this paper, a novel method is proposed to detect common abnormalities in Wireless Capsule Endoscopy (WCE) video frames including Lymphoid Hyperplasia, ulcer, and angiodysplasia lesions. Inspecting WCE video frames to detect abnormality is a tedious task for physicians. One important step in the proposed approach is to extract the region of interest (ROI), i.e., suspicious region, using the expectation–maximization (EM) algorithm. Suspicious regions in WCE frames are segmented using the EM algorithm considering the color and texture information of the image. Then, suitable descriptors associated with the shape, texture, and color of ROIs are examined for further analysis. These descriptors include histogram of gradients for shape, local binary patterns for texture and different statistical characteristics from pixel values for color information. These features are then fed to a support-vector machine for classification. The results show that the proposed approach can detect abnormalities in WCE frames with the accuracy of 91.3%. [ABSTRACT FROM AUTHOR]

An outbreak of food poisoning in New South Wales (NSW) Australia in 2018, caused by Salmonella enterica serovar Enteritidis phage type 12 (PT12), was traced to eggs consumed from a NSW layer flock. This was the first report of Salmonella Enteritidis infection in NSW layer flocks, despite ongoing environmental monitoring. Clinical signs and mortalities were minimal in most flocks, although seroconversion and infection were demonstrated in some flocks. An oral dose–response challenge study with Salmonella Enteritidis PT12 was undertaken in commercial point-of-lay hens. Cloacal swabs collected at 3, 7, 10, and 14 days postinoculation and caeca, liver, spleen, ovary, magnum, and isthmus tissues collected at necropsy at either 7 or 14 days were processed for Salmonella isolation (AS 5013.10-2009 from ISO6579:2002). Histopathology was performed on the above tissues, as well as lung, pancreas, kidney, heart, and additional intestinal and reproductive tract tissues. Salmonella Enteritidis was consistently detected in cloacal swabs between 7 and 14 days postchallenge. The Salmonella Enteritidis PT12 isolate successfully colonized the gastrointestinal tract, liver, and spleen of all hens orally challenged with 107, 108, and 109Salmonella Enteritidis, and less consistently colonized their reproductive tracts. On histopathology, mild lymphoid hyperplasia in the liver and spleen, along with hepatitis, typhlitis, serositis, and salpingitis, was observed at 7 and 14 days postchallenge, with a greater proportion of affected birds in the two higher dose groups. Diarrhea and culture of Salmonella Enteritidis from heart blood were not detected in challenged layers. The NSW isolate of Salmonella Enteritidis PT12 was able to invade and colonize the birds' reproductive tracts as well as a wide range of other tissues, indicating the potential for these naive commercial hens to contaminate their eggs. La inoculación oral de gallinas ponedoras en el pico de postura con la cepa de Salmonella Enteritidis PT12 del brote en Nueva Gales del Sur causa infección, pero una histopatología mínima. Un brote de intoxicación alimentaria en Nueva Gales del Sur (NSW), Australia en 2018, causado por Salmonella enterica serovar Enteritidis fagotipo 12, se rastreó hasta los huevos consumidos de una parvada de ponedoras de NSW. Este fue el primer informe de infección por Salmonella Enteritidis en parvadas de ponedoras de NSW, a pesar del monitoreo ambiental continuo. Los signos clínicos y la mortalidad fueron mínimos en la mayoría de las parvadas, aunque se demostró seroconversión e infección en algunas parvadas. Se llevó a cabo un estudio de desafío oral para evaluar la dosis y su respuesta para Salmonella Enteritidis PT12 en gallinas ponedoras comerciales. Los hisopos cloacales recolectados a los tres, siete, diez y 14 días posteriores a la inoculación y los tejidos de ciego, hígado, bazo, ovario, magnum e istmos recolectados en la necropsia a los siete o 14 días se procesaron para el aislamiento de Salmonella (AS 5013.10-2009 del estándar ISO6579: 2002). Se realizó histopatología en los tejidos anteriormente mencionados, así como de pulmón, páncreas, riñón, corazón y tejidos intestinales y del tracto reproductivo adicionales. Salmonella Enteritidis se detectó consistentemente en hisopos cloacales entre los siete y 14 días después del desafío. El aislado de Salmonella Enteritidis PT12 colonizó con éxito el tracto gastrointestinal, el hígado y el bazo de todas las gallinas desafiadas por vía oral con dosis de 107, 108 y 109 de Salmonella Enteritidis, pero colonizó de manera menos consistente sus tractos reproductivos. En la histopatología, se observó hiperplasia linfoide leve en el hígado y el bazo, junto con hepatitis, tiflitis, serositis y salpingitis, a los siete y 14 días posteriores a la exposición, con una mayor proporción de aves afectadas en los dos grupos de dosis más altas. En las ponedoras desafiadas no se detectaron diarrea ni cultivo de Salmonella Enteritidis de sangre colectada del corazón. El aislamiento de Salmonella Enteritidis PT 12 de Nueva Gales del Sur pudo invadir y colonizar los tractos reproductivos de las aves, así como una amplia gama de otros tejidos, lo que indica el potencial de estas gallinas comerciales sin inmunidad para contaminar sus huevos. [ABSTRACT FROM AUTHOR]

This study was evaluating histopathological changes in lung tissue induced by formaldehyde vapors in mice. A group of 20 adult male mice was divided into two groups for this purpose. The mice in group (I) are the controls, whereas the mice in groups (II) were exposed to formaldehyde vapors inhalation in a toxic dose (0.5 PPM) every day for two months in the students dissecting room of South Valley University's Faculty of Veterinary Medicine. Lung samples were prepared for light microscopic examination after exposure. Gross structural abnormalities in the lungs were identified, including congestion in most lobes and localized pneumonic organization. Thickening of the alveolar septum, epithelial hyperplasia in the bronchioles, proliferative capillaries, pulmonary vasculitis, and hyperplastic lymphocytic aggregations in the parabronchiolar area, pulmonary fibrosis, and precancerous modifications were detected under light microscopy (metaplasia of goblet cells and dysplasia of the bronchiolar epithelium). It was found that inhaling formaldehyde has an irritating toxic effect in addition to its harmful carcinogenic effect on the lungs of mice, which is related to exposure durations.

Introduction:Benign lymphoid hyperplasia uncommonly involves the larynx. Involvement of glottis and subglottis is even rare, considering sparse lymphatic supply compared to supraglottis. Case Report: A young female presented to emergency with worsening breathing difficulty. After securing the airway, she had found to have circumferential glottis and subglottic mucosa covered firm swelling. Histopathological evaluation of the swelling showed it to be benign lymphoid hyperplasia. Coblation assisted excision of the lesion was done, and the patient became asymptomatic without any recurrence.Conclusion:Idiopathic lymphoid hyperplasia is a very rare entity to present as glottis and subglottic lesions. Probably, it's the first case to be reported in the literature as laryngeal involvement sparing the supraglottis.

Morphea profunda or subcutaneous (deep) morphea is a variant of localized morphea, characterized by one or more ill-defined, deep sclerotic plaque. Preferential sites are the abdomen, trunk, sacral area, or extremities. The presence of hyperplastic lymphoid follicles in the context of the sclerotic bands of morphea is rarely described. Localized scleroderma is sustained by a profibrotic inflammatory profile. Transforming growth factor-β (TGF-β), an imbalance between functional subclasses of T-lymphocytes (innate immune cells) has a role in activate collagen deposition. In this case report, we present two cases of morphea profunda with lymphoid follicular hyperplasia. A systematic review of the literature on the pathophysiology of localized scleroderma is also presented, with particular reference to the presence of lymphoid structures.

Cutaneous lymphoid hyperplasia (CLH), also known as cutaneous pseudolymphoma, is a spectrum of benign conditions characterized by reactive B‐ and T‐cell cutaneous lymphocytic infiltrates. B‐cell lymphoid proliferations are a heterogenous group of non‐neoplastic cutaneous diseases that must be histopathologically distinguished from cutaneous B‐cell lymphomas. These proliferations can be observed as reactive phenomena to infections, medications, allergens, neoplasms, and more. Furthermore, there are many inflammatory conditions that present with reactive B‐cell infiltrates, including actinic prurigo, Zoon balanitis, Rosai‐Dorfman disease, and cutaneous plasmacytosis. This review summarizes multiple cutaneous B‐cell lymphoid proliferations within the major categories of reactive and disease‐associated CLH. Further we discuss major discriminating features of atypical CLH and malignancy. Understanding the specific patterns of B‐cell CLH is essential for the proper diagnosis and treatment of patients presenting with such lesions. [ABSTRACT FROM AUTHOR]

Background: Acute appendicitis is the commonest abdominal condition requiring emergency surgical intervention. Objective: To determine the spectrum and frequency of various histopathological findings in appendectomy specimens of patients presenting with acute appendicitis at Central Park Medical College/Central Park Teaching Hospital, Lahore. Method: It was cross-sectional study commencing from 15 April 2016 to 15 April 2021 conducted at the Pathology Department of Central Park Medical College, Lahore. Relevant record from previous histopathology reports were retrieved. Data were compiled using SPSS version 21. Frequency and percentages were calculated for age, gender, and histopathological findings. Test of significance (Chi square) was used to observe the relation of age and gender with morphology. Results: A total of 429 appendectomy specimens were included in the study. These included 243 cases (56.6%) from males and 186 cases (43.4%) from females. Patients ranged in age from 1 to 75 years with a maximum of 158 cases (36.8%) in the age range of 11 to 20 years. On histopathology the commonest diagnosis was acute appendicitis in 125 cases (29.13%) with associated findings of peri appendicitis in 77 cases (18%), acute suppurative appendicitis in 61 cases (14.2%), perforated appendices in 11 cases (2.6%), fibrosed lumina in 7 cases (1.63%) and gangrenous appendix in 1 case (0.23%). Lymphoid hyperplasia constituted the second most frequent diagnosis in 114 cases (26.6%). Other significant unsuspected findings were pinworm infestation in 5 cases (1.16%), granulomatous inflammation in 2 cases (0.5%) and endometriosis in 2 cases (0.5%). Incidental tumors included 3 cases (0.7%) of neuroendocrine tumors (carcinoid) and 1 case (0.23%) of Low Grade Appendiceal Mucinous Neoplasm (LAMN). Normal appendectomies were reported in 4 cases (0.93%). Chi-square test of association was used to observe the statistically significant relation of age and gender with histopathological findings. Conclusion: Histopathological examination of appendectomy specimens is the "gold standard" for accurate diagnosis and confirmation of the clinical diagnosis of "acute appendicitis". Certain coexistent, unexpected incidental findings may also be detected. [ABSTRACT FROM AUTHOR]

Background/Aims: Although localized lymphoid hyperplasia (LLH) of the rectum is occasionally observed, its clinical implications are unclear. This study aimed to investigate the clinical course and significance of LLH of the rectum. Methods: We identified 65 patients diagnosed with LLH of the rectum using a histopathologic examination and who received follow-up endoscopies between January 2009 and June 2015. Patients with a history of inflammatory bowel disease, lymphoma, familial adenomatous polyposis, or uncontrolled malignancy and patients who underwent scar biopsy after endoscopic resection or surgery were excluded. Endoscopic findings and clinical courses were analyzed. Results: During the median follow-up of 31 months (interquartile range, 19 to 40 months), 81.5% (53/65) of LLHs of the rectum were resolved. Clinically significant diseases, including ulcerative colitis (UC, n=5) and mucosa-associated lymphoid tissue (MALT) lymphoma (n=1), were diagnosed in 9.2% of patients (6/65). The other six patients showed no significant changes in the lesion (n=3) or a waxing and waning appearance (n=3). According to endoscopic findings, all of the 47 polypoid types showed resolution or waxing and waning patterns. Five of the 11 nodular types (45.5%) developed into UC. One of the seven submucosal tumor (SMT)-like types (14.3%) developed into MALT lymphoma. Conclusions: LLH of the rectum with persistent symptoms or the endoscopic appearance of the nodular or SMT-like type may lead to clinically significant disease. Risk stratification according to endoscopic findings and careful surveillance are required for these lesions.

The relative frequencies of splenic lymphoid hyperplasia, complex hyperplasia, stromal sarcoma, and histiocytic sarcoma diagnoses among splenectomized dogs with splenic fibrohistiocytic nodules were estimated overall and by demographic categories. Keywords: spleen; fibrohistiocytic nodules; lymphoid hyperplasia; complex hyperplasia; dog; sarcoma; survival EN spleen fibrohistiocytic nodules lymphoid hyperplasia complex hyperplasia dog sarcoma survival N.PAG N.PAG 13 04/26/22 20220415 NES 220415 1. [Extracted from the article]

Thymic lymphoid hyperplasia is a common age-related finding, which occurs particularly in female CD-1 mice. The main differential diagnoses are malignant lymphoma and thymoma. A systematic investigation of control groups from two carcinogenicity studies was performed including measurements of thymic size, and the immunohistochemistry (IHC) markers pan-Cytokeratin (pan-CK) for thymic epithelial cells; CD3 and CD45R/B220 for T and B lymphocytes, respectively; CD31 for endothelial cells; and F4/80 for macrophages. Thymoma can be differentiated by increased numbers of proliferating epithelial cells demonstrated by pan-CK IHC staining. Differentiation between lymphoid hyperplasia and lymphoma is more challenging as a mixture of B and T lymphocytes can be present in both findings. The present investigation showed that the thymic perivascular space is the compartment where the increased numbers of lymphocytes in hyperplasia are localized and not the medulla, as previously thought. The lymphoepithelial compartment is atrophic to the same extent in thymi diagnosed with age-related involution or lymphoid hyperplasia. Both diagnoses are thus related to variations in lymphoid cellularity of the nonepithelial perivascular space, which is continuous with the perithymic tissue. Likewise, lymphomas have a predilection to colonize the perivascular space and to spare the lymphoepithelial compartment. [ABSTRACT FROM AUTHOR]

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Lymphoid hyperplasia is a type of tumor-like hyperplasia of lymphoid tissue. There have been few reports on lymphoid hyperplasia of the gallbladder. Here, we report a case of lymphoid hyperplasia with a polyp form of the gallbladder macroscopically mimicking carcinoma. Liver dysfunction was diagnosed in a 75-year-old woman who presented with a gallbladder mass measuring 20 mm during an annual health checkup. Antibody tests for infectious diseases were positive for anti-HBs and anti-HBc antibodies. Accordingly, a laparoscopic cholecystectomy was performed. Macroscopically, the mass was a papillary/sessile tumor (29 × 25 mm) located in the fundus of the gallbladder. Histologically, the tumor was accompanied by an erosion on a portion of the surface layer, while the remaining epithelium showed regenerative changes and mild hyperplasia. No atypia was observed in the constituent epithelium. Hyperplasia of the polarized lymphoid follicles was observed in the interstitium, and tingible body macrophages were scattered in the germinal center. Immuno-histologically, the germinal center showed CD20 positivity, weak CD10 positivity, Bcl-2 negativity, and a high Ki-67 index (MIB-1). These findings suggested that the proliferating lymphoid follicles were reactive rather than neoplastic. Therefore, we diagnosed the patient with lymphoid hyperplasia of the gallbladder and chronic cholecystitis. [ABSTRACT FROM AUTHOR]

Introduction: Benign lymphoid hyperplasia uncommonly involves the larynx. Involvement of glottis and subglottis is even rare, considering sparse lymphatic supply compared to supraglottis. Case Report: A young female presented to emergency with worsening breathing difficulty. After securing the airway, she had found to have circumferential glottis and subglottic mucosa covered firm swelling. Histopathological evaluation of the swelling showed it to be benign lymphoid hyperplasia. Coblation assisted excision of the lesion was done, and the patient became asymptomatic without any recurrence. Conclusion: Idiopathic lymphoid hyperplasia is a very rare entity to present as glottis and subglottic lesions. Probably, it's the first case to be reported in the literature as laryngeal involvement sparing the supraglottis. [ABSTRACT FROM AUTHOR]

In the 5th edition of the World Health Organization (WHO) Classification of Head and Neck Tumours, the discussion of hematolymphoid proliferations is substantially reorganized and expanded in comparison to the prior edition. The 5th edition includes, in addition to hematolymphoid neoplasms, reactive lymphoid proliferations. Much more information on hematolymphoid proliferations that commonly affect cervical lymph nodes, in addition to those affecting extranodal sites in the head and neck, is included. For the first time, there are dedicated sections on multiple entities, including recently described lymphoproliferative disorders such as EBV+ mucocutaneous ulcer and pediatric-type follicular lymphoma, and several types of histiocytic neoplasms. Tremendous advances have been made in understanding the genetic features that underlie the pathogenesis of hematolymphoid neoplasms, and these have been incorporated into the WHO Classification. [ABSTRACT FROM AUTHOR]

Morphea profunda or subcutaneous (deep) morphea is a variant of localized morphea, characterized by one or more ill-defined, deep sclerotic plaque. Preferential sites are the abdomen, trunk, sacral area, or extremities. The presence of hyperplastic lymphoid follicles in the context of the sclerotic bands of morphea is rarely described. Localized scleroderma is sustained by a profibrotic inflammatory profile. Transforming growth factor-β (TGF-β), an imbalance between functional subclasses of T-lymphocytes (innate immune cells) has a role in activate collagen deposition. In this case report, we present two cases of morphea profunda with lymphoid follicular hyperplasia. A systematic review of the literature on the pathophysiology of localized scleroderma is also presented, with particular reference to the presence of lymphoid structures. [ABSTRACT FROM AUTHOR]

Objectives: In this retrospective study, we report a series of benign lymph nodes showing small populations of normal B-cell precursors characterized by flow cytometry and immunohistochemistry.Methods: Ten cases identified during clinical flow cytometry practice were retrospectively reanalyzed with particular attention to hematogone categorization and enumeration. Immunohistochemical staining was performed on five excisional lymph node biopsy specimens to characterize the morphologic correlate.Results: Populations of hematogones ranging from 0.13% to 1.86% (median, 0.51%) of all viable leukocytes were demonstrated in 10 benign lymph node samples from eight different patients ranging in age from 17 to 45 years (median, 37.5). These hematogones showed a characteristic immunophenotype (CD19+/CD10+) and maturational pattern by flow cytometry, with progression from stage 1 (median, 0.03%) to stage 2 (median, 0.19%) to stage 3 (median, 0.26%) seen in all cases. Immunohistochemical staining on five excisional biopsy specimens demonstrated a distinct perisinusoidal distribution of CD10+/CD20+ cells with a subset of TdT+ cells, providing a morphologic correlate.Conclusions: To our knowledge, this is the first study to characterize distinct hematogone populations within benign lymph nodes by both flow cytometry and immunohistochemistry. Recognizing these normal B-cell precursor populations is important to avoid their miscategorization as a CD10+ B-cell neoplasm. [ABSTRACT FROM AUTHOR]

Abstract Background Primary intestinal follicular lymphoma (PI-FL) is a rare and indolent lymphoma and is challenging for diagnosis with endoscopic biopsy specimens. Whole slide imaging (WSI) has been increasingly used for assisting pathologic diagnosis, but not for lymphoma yet, probably because there are usually too many immunostained sections in a single case. In this study we attempted to identify morphological clues of PI-FL in the endoscopic biopsy specimens by measuring various parameters using WSI. Methods We retrospectively investigated 21 PI-FL cases, and scanned the HE sections from 17 of these cases with endoscopic biopsy specimens. Sections from 17 intestinal biopsies showing reactive lymphoid hyperplasia were scanned for comparison. The density and diameter of lymphoid follicles and the shortest distance of these follicles to the surface epithelia were measured on WSI. Comparisons of the aforementioned parameters were made between the neoplastic and reactive follicles. Results The density of follicles was significantly higher in PI-FL than that of reactive hyperplasia (median 0.5 vs. 0.2/mm2; p

Background: Appendectomy remains the most common emergency surgery. With the lack of literature from Saudi Arabia regarding the treatment for appendix disorders, this study aimed to identify the common motives for appendectomy in Northern Saudi Arabia. Methodology: Data referring to be resected appendix patients who were diagnosed during the period from January 2018 to December 2018 were included in the present study. The diagnosis of the resected appendix was confirmed by conventional histopathology. Results: The most common cause for the appendectomy was acute appendicitis followed by gangrenous perforated appendicitis, chronic appendicitis, and lymphoid hyperplasia, representing 85/129(66%), 33/129(26%), 8/129(6%), and 3/129(2%), in this order. Conclusion: Appendectomy is a common procedure for the treatment of a large section of patients with appendicitis and appendicitis like clinical features. Acute appendicitis was the most motive for appendectomy followed by gangrenous perforated appendicitis in Northern Saudi Arabia.

Abstract Objective Lymphoid hyperplasia is endoscopically observed as multiple small whitish round nodules or spots. This retrospective study was performed to examine the prevalence of that finding in patients with Barrett's epithelium and its relationship with the status of H. pylori infection. Methods The study subjects were 3353 patients (males 2186, females 1167; mean age 55.2 ± 9.4 years) in whom the status of H. pylori infection had been determined. The presence of Barrett's epithelium ≥ 5 mm in length was endoscopically determined, and then endoscopic observations with blue laser imaging were used to investigate the presence of lymphoid hyperplasia in those areas. Results Barrett's epithelium was diagnosed in 1884 (56.2%) of the subjects, and endoscopic findings of lymphoid hyperplasia were observed in 402 (21.3%) of those with Barrett's epithelium. Lymphoid hyperplasia in Barrett's epithelium was not present in any without a current or prior H. pylori infection, while the prevalence of lymphoid hyperplasia in H. pylori‐positive and post‐eradicated subjects was 48.4% and 30.4%, respectively (p < 0.001). Multiple logistic regression analysis revealed that female gender, younger age, and higher degree of gastric mucosal atrophy were significant factors related to lymphoid hyperplasia positivity. In addition, the duration after H. pylori eradication was negatively correlated with its prevalence. Conclusion Endoscopic findings of cardiac lymphoid hyperplasia were well correlated with H. pylori infection, although prevalence decreased over time following bacterial eradication.

Introduction: Intracranial Castleman disease (CD) is an extremely rare and poorly-understood lymphoproliferative disorder with only a handful of case reports in the literature. CD most commonly presents with focal extracranial lymph node enlargement.Case report:A 30-year-old female presented with headaches and generalized tonic-clonic seizure. Imaging demonstrated an enhancing extra-axial dural-based mass in the right parietal convexity. The patient underwent gross total resection via a right parietal craniotomy and was discharged without complications. At 6-month follow-up, the patient remained neurologically intact with resolved preoperative symptomatology. Conclusions: The authors present a rare case of intracranial CD of the dura and elucidate specific histopathological characteristics. This case illustrates the importance of resection of the enhancing dural component in addition to the utility of a follow-up whole body PET-CT. Imaging characteristics of CD mimic an en plaque meningioma, and neurosurgical and hematologic management strategies of CD are unique.

One of the complications of common variable immunodeficiency (CVID) is the development of lymphoid malignancy. In this retrospective, single‐center study of 647 CVID subjects followed over 4 decades, we present immunologic and clinical phenotypes, pathology, treatment, and outcomes of 45 patients (15 males and 30 females, 7%) who developed 49 lymphoid malignancies. The mean age at CVID diagnosis was 42.6 years) and at lymphoma diagnosis was 48.8 years. Of the 41 with known follow up, 29 (70%) have died, 27 of these due to this diagnosis. Twelve are alive, in remission or have achieved cure; four others were alive at last encounter. Some patients had a history of only recurrent infections (36.3%); others had autoimmunity (33%), enteropathy (20%), and/or granulomatous disease (11%). Six had previously been treated for another cancer. This report also includes 6 additional living CVID patients who had been diagnosed with NHL; 4 were given treatment for this. However, on pathology review, the initial diagnosis was reversed, as the findings were more consistent with a benign lymphoproliferative process. This study outlines the high incidence of lymphoma in this single CVID cohort, and some of the diagnostic challenges presented due to immune dysregulation characteristic of this immune defect. [ABSTRACT FROM AUTHOR]

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Objective:To evaluate the histopathological findings in appendectomy materials with E. vermicularis infection.Methods:Appendectomy materials with E. vermicularis infection of 24 cases were evaluated for the presence of acute inflammation, congestion, hemorrhage, perforation, lymphoid hyperplasia (LH), necrosis, granuloma, fecalith, obliteration, hyalinization, eosinophilic infiltration and mucosal architectural distortion.Results:The frequency of E. vermicularis among 3222 appendectomies that were scanned for the study was 0.74% (24/3222). Female: male ratio was 1:1 and the median age was 12±9.34 years. The most common findings were LH (100%), and congestion (91.7%) Acute inflammation was found in one third (n=8), with phlegmonous inflammation and/or periappendicitis in 4 of them. The patients with periappendicitis were significantly younger (mean age 4 vs. 14.2 years, p=0.008). Feces was present in the lumen in 79.1% of the patients (fecalith in 25%, soft feces in 29.1% and feces mixed with blood and/or suppuration in 25%). In 6 cases (25%), only E. vermicularis was observed in the lumen, with acute appendicitis in 2 of them. Appendiceal lumen was completely obstructed in 12.5% (n=3), while it seemed narrow due to extensive LH in 3 (12.5%) cases. Fibrous obliteration was seen in 4 patients and it was correlated with age and eosinophil count in lamina propria p

Background: Subcutaneous vaccination or desensitization may induce persistent nodules at the injection sites. Without the knowledge of prior injection, histopathological work‐up may be challenging. Objective: Aim of this study was to contribute to the histopathological work‐up of unclear subcutaneous nodules, especially their differentiation from cutaneous lymphoma. Methods: We retrospectively reviewed clinical data and histopathological slides of four patients with subcutaneous nodules, which were suspected to suffer from cutaneous T‐ or B‐cell lymphoma. Sections of these cases and 12 negative controls were stained with hematoxylin and eosin and a standardized immunohistochemical panel of B‐ and T‐cell markers including EBER in situ hybridization as well as electron microscopy. Results: In all cases, large histiocytes with granular cytoplasm compatible with intracellular aluminum hydroxide were present. EBER in situ hybridization revealed positive staining of these granular histiocytes while staining was absent in negative controls. Limitations: Post hoc completion of medical history revealed that vaccination or specific immunotherapy had been applied before at the biopsy site in only three out of four patients; one patient was lost to follow‐up. Conclusion: EBER in situ hybridization is an adjunctive tool to differentiate aluminum‐induced granuloma/lymphoid hyperplasia from other forms of pseudolymphoma and cutaneous B‐ or T‐cell lymphomas. [ABSTRACT FROM AUTHOR]

Background/Aims: Although localized lymphoid hyperplasia (LLH) of the rectum is occasionally observed, its clinical implications are unclear. This study aimed to investigate the clinical course and significance of LLH of the rectum. Methods: We identified 65 patients diagnosed with LLH of the rectum using a histopathologic examination and who received follow-up endoscopies between January 2009 and June 2015. Patients with a history of inflammatory bowel disease, lymphoma, familial adenomatous polyposis, or uncontrolled malignancy and patients who underwent scar biopsy after endoscopic resection or surgery were excluded. Endoscopic findings and clinical courses were analyzed. Results: During the median follow-up of 31 months (interquartile range, 19 to 40 months), 81.5% (53/65) of LLHs of the rectum were resolved. Clinically significant diseases, including ulcerative colitis (UC, n=5) and mucosa-associated lymphoid tissue (MALT) lymphoma (n=1), were diagnosed in 9.2% of patients (6/65). The other six patients showed no significant changes in the lesion (n=3) or a waxing and waning appearance (n=3). According to endoscopic findings, all of the 47 polypoid types showed resolution or waxing and waning patterns. Five of the 11 nodular types (45.5%) developed into UC. One of the seven submucosal tumor (SMT)-like types (14.3%) developed into MALT lymphoma. Conclusions: LLH of the rectum with persistent symptoms or the endoscopic appearance of the nodular or SMT-like type may lead to clinically significant disease. Risk stratification according to endoscopic findings and careful surveillance are required for these lesions. [ABSTRACT FROM AUTHOR]

We describe an otherwise healthy 24-year-old woman with reactive lymphoid hyperplasia of one lacrimal gland. She was found to have modest elevation of serum IgG4 and high density of IgG4+ plasma cells in her lacrimal gland, ranging from 40% to 60% of IgG+ plasma cells. The patient transiently responded to systemic corticosteroids before treatment with rituximab. IgG4-rich reactive lymphoid hyperplasia of the lacrimal gland is neither an established part of IgG4-related disease spectrum nor a known precursor lesion to lymphoma. Although there is a plausible risk of transforming to IgG4-related disease or to lymphoma, the biological potential and natural history of IgG4-rich reactive lymphoid hyperplasia remains to be determined. [ABSTRACT FROM AUTHOR]

Background: Primary intestinal follicular lymphoma (PI-FL) is a rare and indolent lymphoma and is challenging for diagnosis with endoscopic biopsy specimens. Whole slide imaging (WSI) has been increasingly used for assisting pathologic diagnosis, but not for lymphoma yet, probably because there are usually too many immunostained sections in a single case. In this study we attempted to identify morphological clues of PI-FL in the endoscopic biopsy specimens by measuring various parameters using WSI. Methods: We retrospectively investigated 21 PI-FL cases, and scanned the HE sections from 17 of these cases with endoscopic biopsy specimens. Sections from 17 intestinal biopsies showing reactive lymphoid hyperplasia were scanned for comparison. The density and diameter of lymphoid follicles and the shortest distance of these follicles to the surface epithelia were measured on WSI. Comparisons of the aforementioned parameters were made between the neoplastic and reactive follicles. Results: The density of follicles was significantly higher in PI-FL than that of reactive hyperplasia (median 0.5 vs. 0.2/mm2; p < 0.01). Furthermore, the neoplastic follicles were significantly larger (median diameter 756.9 vs. 479.7 μm; p < 0.01). The shortest distance of follicles to the surface epithelia tended to be closer in PI-FL (104.7 vs. 177.8 μm, p = 0.056), but not statistically significant. Conclusions: In this study we found that in PI-FL the density and diameter of lymphoid follicles as measured from WSI were significantly different from that of intestinal reactive lymphoid hyperplasia. When facing the diagnostic challenge between these two entities in routine practice, pathologists might be alerted by these morphological clues and request for immunohistochemistry for differential diagnosis. [ABSTRACT FROM AUTHOR]

Background: The BTB domain of B‐cell lymphoma 6 (BCL6) protein was identified as a therapeutic target for B‐cell lymphoma. This study compared the pharmacokinetics (PK) of the BCL6 BTB inhibitor (FX1) between mice and macaques, as well as evaluating its lymphoid suppressive effect in uninfected macaques with lymphoid hyperplasia. Materials and Methods: Eight uninfected adult Indian rhesus macaques (Macaca mulatta) were used in the study, four animals carrying lymphoid tissue hyperplasia. Plasma FX1 levels were measured by HPLC‐MS/MS. Lymph node biopsies were used for H&E and immunohistochemistry staining, as well as mononuclear cell isolation for flow cytometry analysis. Results: Inhibition of the BCL6 BTB domain with FX1 led to a reduction in the frequency of GC, Tfh CD4+, and Tfh precursor cells, as well as resolving lymphoid hyperplasia, in rhesus macaques. Conclusions: B‐cell lymphoma 6 inhibition may represent a novel strategy to reduce hyperplastic lymphoid B‐cell follicles and decrease Tfh cells. [ABSTRACT FROM AUTHOR]

The rectal tonsil is a rare polypoid lesion exclusively found in the rectum and is considered a reactive proliferation of the lymphoid tissue. Although this lesion is benign, we recommend that it should be differentiated from carcinoid or polypoid type of mucosa-associated lymphoid tissue lymphomas, based on gross findings. In this case report, we describe a case of rectal lesions with a unique appearance in a 41-year-old man. Colonoscopy revealed two 5-mm-sized nodules located opposite from each other on the left and right sides of the lower rectum. Endoscopic mucosal resection was conducted. Histopathologically, both lesions were mainly located in the submucosa and consisted of prominent lymphoid follicles with germinal centers of various sizes. No immunoreactivity of Bcl-2 was seen in the germinal centers. Immunohistochemical staining for kappa and lambda light chains revealed a polyclonal pattern. Therefore, these lesions were diagnosed as rectal tonsils.

Due to the radiological features of the lesion, we suspected an en plaque meningioma and advised the patient to undergo tumor resection. Keywords: lymphoid follicular hyperplasia; lymphoid hyperplasia; lymphoma; meningioma EN lymphoid follicular hyperplasia lymphoid hyperplasia lymphoma meningioma 1 3 3 08/27/21 20210901 NES 210901 GLO:22R6/01sep21:bpa12995-toc-0001.jpg PHOTO (COLOR): . gl 1 BOX Slide scan Access the whole slide scan at http://image.upmc.edu:8080/NeuroPathology/BPA/BPA-21-02-MISC-029.svs/view.apml CLINICAL HISTORY AND NEUROIMAGING A 57-year-old woman suffered two epileptic seizures with paresthesia on the left side of the body and dysarthria. Complete tumor resection was achieved, and the dura above the tumor was resected as well. [Extracted from the article]

Chronic idiopathic ulcers of the colon pose diagnostic challenges due to their elusive etiology and potential resemblance to other intestinal pathologies, such as cecal carcinoma. This case report outlines the clinical course of a 68-year-old female patient who presented to the emergency department (ED) with persistent right lower quadrant pain. Despite multiple hospital visits yielding varied diagnoses, a definitive diagnosis was only made following a laparoscopic partial colectomy, which revealed chronic idiopathic ulcers with transmural scarring and adhesions to adjacent small intestine loops. Histological examination demonstrated a substantial ulcer bed populated by inflammatory cells, including large stellate and spindled stromal cells within the granulation tissue, alongside lymphoid hyperplasia and scar tissue extending into the muscularis propria. The initial presentation of this case could easily be mistaken for appendicitis, diverticulitis, carcinoma, or irritable bowel syndrome, highlighting the significance of considering chronic idiopathic ulcers in the differential diagnosis of patients presenting with cecal masses., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Ansari et al.)

Lymphoid hyperplasia can be an important mimicker of acute appendicitis by creating a non-compressible appendix more than 6 mm in diameter. The aim of this study was to evaluate methods of distinguishing lymphoid hyperplasia and appendicitis on the basis of sonography, lamina propria thickness, and Alvarado scoring. This retrospective study included 259 patients (142 appendicitis, 117 lymphoid hyperplasia). The US (ultrasound) reports of the patients were reviewed and the maximum diameter of the appendix, the presence or absence of increased echogenicity of the surrounding pericaecal fat, local fluid collection, the presence of reactive lymph nodes in the periappendiceal area, and mural hyperemia within the appendix were recorded. The use of additional sonographic criteria, lamina propria thickness (≤1 mm is indicative for appendicitis), or Alvarado scoring (>6 mm is indicative for appendicitis) provided a true-positive diagnosis for acute appendicitis. The presence of local fluid collection in the periappendiceal area and a lamina propria thickness ≤ 1 mm are the most successful parameters for distinguishing appendicitis from lymphoid hyperplasia. [ABSTRACT FROM AUTHOR]