DISEASES OF

LYMPHATIC SYSTEM

Second year
Slides
Reactive hyperplasia of the lymph
node:
• Lymph node showing preserved normal nodal
architecture (The normal lymphoid follicles are
arranged in the cortex and the sinusoids contained
lymph fluid at the center).

• The lymph node is enlarged and the lymphoid follicles

are enlarged, with central paler areas (germinal
centers). There are numerous tangible body
macrophages in the germinal center.

• The nodal sinusoids are dilated and increased in

number.
Normal Reactive
 Germinal

MZ
Hodgkin Lymphoma:
• Section from an enlarged lymph node. partial or complete loss
of the nodal architecture
• replacement of the normal nodal tissue by scattered
polymorphic cells formed of lymphocytes, plasma cells,
esinophiles, histiocytes and the characteristic Hodgkin`s cells
(Reed-Sternberg or RS cells).

• The RS cells are large with double large round, oval vesicular
nuclei, prominent eosinophilic nucleoli and m o d e ra te
amphophilic cytoplasm.

• Several variants of RS cells can be seen including

mononuclear variants (large cells with single round vesicular
nuclei, prominent nucleoli and moderate pale pink cytoplasm),
lacunar variants (large cells with shrunken cytoplasm) and
popcorn variant (with lobulated nuclei).
 Eosinophils

RS
Lymphocyte
The characteristic polymorphic
background
Multiple RS CELLS
popcorn cell It has a large, multilobed, folded nucleus
and is surrounded by small lymphocytes

..
Lacunar cell
 Non-Hodgkin’s lymphoma (NHL):
• Section of an enlarged lymph node showed complete loss
of the nodal architecture.
• There is replacement of the normal nodal tissue by
monomorphic neoplastic lymphoid cells with large
hyperchromatic nuclei, surrounded by a rim of pale
basophilic cytoplasm, with frequent mitosis

The grading of NHL depends on:

• The type of neoplastic lymphoid cells (B. cell lymphoma, T. cell
lymphoma).
• the size of the neoplastic lymphoid cell (small lymphocytes
lymphoma and large cell lymphoma).
• the pattern of its arrangement in the lymph node (follicular
lymphoma, diffuse large cell lymphoma).
NHL
Metastatic carcinoma, LN:
This is a section from a large lymph node.

There is partial loss of the normal nodal

architecture with infiltration and replacement of the
nodal tissue by neoplastic epithelial cells.

The latter are arranged in sheets or cell nests (in

metastatic squamous cell carcinoma) or glands (in
metastatic adenocarcinoma). The neoplastic cells
show all criteria of malignancy of the primary tumor
Lymph Node with Metastatic
Adenocarcinoma
Metastatic squamous cell carcinoma in
LN
JARS OF LYMPHATICS
LYMPHOMA OF SPLEEN
L -3a
LYMPHOMA OF SPLEEN
L -3b
LYMPHOMA OF SPLEEN
L -3c
LYMPHOMA OF LYMPH
NODES
L- 4
METASTATIC
MELANOMA IN A LYMPH
NODE
L- 5
Thank you