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Nodular Lymphoid Hyperplasia

Definition

  • Pulmonary mass or masses formed by reactive lymphiod tissue

Alternate/Historical Names

  • Pseudolymphoma

Diagnostic Criteria

  • Clinical
    • Most are incidental findings
    • Age 19-90
    • Most reported not associated with autoimmune disease or immunodeficiencey
    • Benign
  • High resolution computed tomography (HRCT)
    • Discrete nodule or nodules
      • Usually 2-4 cm
    • Most are subpleural but do not form pleural plaques
  • Histopathologic features
    • Well defined mass or masses
      • Intervening lung is normal
      • Lacks capsule and structure of an intrapulmonary lymph node
    • Prominent germinal centers
    • Interfollicular sheets of plasma cells
    • Mixed polytypic plasma cells, B and T cells
    • Interfollicular fibrosis may be present

Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342

Original posting/updates: 11/20/10

Differential Diagnosis

Nodular Lymphoid Hyperplasia Extranodal Marginal Zone B Cell Lymphoma
Predominantly germinal centers Monomorphous infiltrate, but germinal centers may be present
Involvement of pleura and cartilage rare Pleura and cartilage may be involved
Polyclonal Monoclonal

 

Follicular Bronchiolitis Nodular Lymphoid Hyperplasia
Scattered follicles around bronchioles Numerous germinal centers form mass lesion or lesions

 

Lymphocytic Interstitial Pneumonitis Nodular Lymphoid Hyperplasia
Diffuse involvement of alveolar septa Discrete nodule(s)
Germinal centers, if present, are a minor component Prominent germinal center hyperplasia

 

  • Intrapulmonary lymph nodes have capsules and other architectural features of nodes and are typically smaller than nodular lymphoid hyperplasia

Classification / Lists

Idiopathic Interstitial Lung Diseases

Other Diffuse Parenchymal Lung Diseases

 

Bibliography

  • Abbondanzo SL, Rush W, Bijwaard KE, Koss MN. Nodular lymphoid hyperplasia of the lung: a clinicopathologic study of 14 cases. Am J Surg Pathol. 2000 Apr;24(4):587-97.
  • Guinee DG Jr. Update on nonneoplastic pulmonary lymphoproliferative disorders  and related entities. Arch Pathol Lab Med. 2010 May;134(5):691-701.
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