Virtual Curriculum Series

Reactive Lymphoid Hyperplasia: Diagnostic Pitfalls and How to Avoid Them

Dr. Aliyah R. Sohani, Massachusetts General Hospital and Harvard Medical School

This lecture begins with an overview of normal lymph node morphology, followed by a discussion of the basic patterns of reactive lymphoid hyperplasia and how a pattern-based approach can be useful in both recognizing an enlarged lymph node as benign and determining an etiology for the lymphoid hyperplasia. Specific entities with illustrative case examples are reviewed, including toxoplasma, syphilis, dermatopathic and viral lymphadenitis, and Kikuchi-Fujimoto disease, with an emphasis on helpful ancillary testing and pitfalls to be aware of in order to avoid making an erroneous diagnosis of lymphoma. The lecture concludes with some general considerations to keep in mind when evaluating challenging lymph node specimens lacking a straightforward diagnosis.

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