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Nodular Lymphoid Hyperplasia of the Intestine

Nodular Lymph Hyperplasia Int


Presentation

  • Diffuse nodular lymphoidhyperplasia with selective IgA deficiency syndrome presenting with intestinal lymphoma. MOJ Clin Med Case Rep. 2016;4(5):116‒118.[medcraveonline.com]
  • We experienced two cases of nodular lymphoid hyperplasia of the small intestine with hypogammaglobulinemia (IgA deficiency) and without hypogammaglobulinemia presented with epigastric discomfort.[e-ce.org]
  • Modern Surgical Pathology, 2nd Edition presents today's most complete, current, and practical assistance in evaluating and signing out surgical specimens.[books.google.com]
  • These nodules are well outlined in the areas of air-barium contrast. ( D ) Nodules of lymphoid hyperplasia are also present in the terminal ileum. (From Maurice M. Reeder: Radiology 93:427, 1969).[isradiology.org]
  • Crypt abscesses may be present Granulomas are present in about 15-36% of biopsied cases Present in over half of colectomy specimens Compact aggregates of epithelioid histiocytes Non-necrotic Multinucleated giant cells may be present May be seen at all[surgpathcriteria.stanford.edu]
Pathologist
  • Edited by four leading surgical pathologists - Noel Weidner, MD, Richard J. Cote, MD, Saul Suster, MD and Lawrence M.[books.google.com]
  • Whenever a malignant diagnosis is being considered benign reactive disorders must be ruled out by an experienced pathologist. This is the final page of the Benign White Cell Disorders. The next page begins the Leukemia section.[med-ed.virginia.edu]
  • Jejunum Uncommonly seen by pathologists. May be seen in the context of a resection done for a bowel obstruction. Ileum This is seen occasionally -- often in the context of IBD and more specifically Crohn's disease.[librepathology.org]
  • […] surface Reactive atypia rarely extends to the luminal surface Dysplasia may be focal, requiring adequate sampling Recommended sampling is 4 biopsies every 10 cm of colorectum A diagnosis of dysplasia should be confirmed by an experienced gastrointestinal pathologist[surgpathcriteria.stanford.edu]
Cervical Lymphadenopathy
  • Physical examination of the patient was unremarkable apart from bilateral cervical lymphadenopathy previously biopsied.[medcraveonline.com]
Intestinal Disease
  • GIT is considered the largest lymphoid system in the body, so intestinal diseases are not surprisingly associated with the immunodeficiency syndromes.[medcraveonline.com]
  • Colonic Diseases Also called: Large intestine diseases Your colon, also known as the large intestine, is part of your digestive system. It's a long, hollow tube at the end of your digestive tract where your body makes and stores stool.[icdlist.com]
  • Immunoproliferative small intestinal disease, / Mediterranean lymphoma: B-cell lymphoma usually arises in children and young adults with Mediterranean ancestry. Usually located in the distal portion of duodenum and upper jejunum.[histopathology-india.net]
  • Khojasteh A, Haghshenass M, Haghighi P (1983) Immunoproliferative small intestinal disease: A “Third-World lesion”. N Engl J Med 308:1401–1405 Google Scholar 16.[link.springer.com]
Chronic Abdominal Pain
  • Strongyloidosis occasionally results in chronic abdominal pain mimicking peptic ulcer disease and cholecystitis. This can happen due to persistent infection, especially in the setting of chronic use of proton pump inhibitors (PPI).[uscapknowledgehub.org]

Workup

  • Provides all the necessary tools to make a comprehensive diagnostic workup including data from ancillary techniques and molecular findings whenever appropriate.[books.google.com]
Human Herpesvirus 8
  • One report described a possible role of human herpesvirus 8 (HHV-8) in the lymphoproliferative disorders in patients with common variable immunodeficiency.[emedicine.medscape.com]
Lymphocytic Infiltrate
  • Histologic finding of the duodenal bulb showed small round mature lymphocyte infiltration and reactive follicle with germinal center in two cases. We report two cases with a brief reviews of literature.[e-ce.org]
  • There was a mild increase in lymphocytic infiltration of lamina propria of gastric mucosa without atypical lymphocytes and lymphoepithelial lesions. In small bowel mild villous blunting and atrophy without crypt hyperplasia was seen.[ijpmonline.org]
  • infiltration in the background of dense keloidlike fibrosis Clue 17 良性の乳管周囲を同心円状に取り巻く小型腫瘍細胞 Targetoid pattern(tumor cells concentrically arranged around ducts) Clue 18 ローゼンタール線維(棍棒状の好酸性無構造物) Rosenthal fibers(thick, elongated, eosinophilic structures)[kinpodo-pub.co.jp]
Lymph Node Hyperplasia
  • FOLLICULAR rheumatoid arthritis giant lymph node hyperplasia (Castleman's disease) AIDS (persistent generalized lymphadenopathy)* idiopathic (most common) SINUS sinus histiocytosis with massive lymphadenopathy lymphangiogram effect * increasingly frequent[med-ed.virginia.edu]

Treatment

  • Following up patients without any treatment may lead to malignant progression, while surgical treatment may result in justified radical resections.[medcraveonline.com]
  • Five new chapters, additional expert authors, expanded tables, and coverage of the current clinical approach to management and treatment options, particularly screening and surveillance recommendations for preneoplastic disorders, round out this unique[books.google.com]
  • The patient’s diarrhea abated with metronidazole treatment; she was counseled about the risk of infection associated with common variable immunodeficiency.[nejm.org]
  • Treatment may involve diet, medicines and in some cases, surgery.[icdlist.com]
  • Pharmacological treatment of eosinophilic gastrointestinal disorders. Expert Rev Clin Pharmacol. 2016;9(9):1195-1209. DOI: 10.1080/17512433.2016.1190268 [ Links ][scielo.org.mx]

Prognosis

  • Pulmonary malignant lymphomas and pseudolymphomas: classification, therapy, and prognosis. Cancer. 1963;16:928–955. Okubo H, Maekawa H, Ogawa K, Wada R, Sekigawa I, Iida N, Maekawa T, Hashimoto H, Sato N.[genrevista.org]
  • Saltzstein SL (1963) Pulmonary Malignant Lymphomas and Pseudolymphomas: Classification, Therapy, and Prognosis. Cancer 16: 928-955.[pancreas.imedpub.com]
  • It usually runs a benign and self-limiting course in children whereas in adults the prognosis is uncertain [6].[medresearch.in]

Etiology

  • DLNH is a rare benign condition of unknown etiology that may occur in any age group. 1 It usually regresses in children and it was thought to be associated with delayed type of food hypersensitivity.[medcraveonline.com]
  • Diffuse duodenal nodular lymphoid hyperplasia: a large cohort of patients etiologically related to Helicobacter pylori infection. BMC Gastroenterol. 2011;11:36–47. PubMedCentral PubMed CrossRef 2.[springermedizin.at]
  • Each of these morphologically recognizable patterns is associated with certain antigenic stimuli, thus the morphologic type of lymphadenopathy may offer clues as to the etiology of the lymphadenopathy.[med-ed.virginia.edu]
  • Here, we report on a large cohort of patients with NLH, etiologically related to H. pylori infection.[bmcgastroenterol.biomedcentral.com]
  • Diffuse duodenal nodular lymphoid hyperplasia: a large cohort of patients etiologically related to Helicobacter pylori infection. BMC Gastroenterology. 2011;11:36. Garg V, Lipka S, Rizvon K, Singh J, Rashid S, Mustacchia P.[revistagastrocol.com]

Epidemiology

  • Eosinophilic gastroenteritis: epidemiology, diagnosis and management. Paediatr Drugs. 2002;4(9):563-570. [ Links ] 23. DeBrosse CW, Case JW, Putnam PE, Collins MH, Rothenberg ME.[scielo.org.mx]
  • Nonprotruding colorectal neoplasms: epidemiologic viewpoint. World J Surg. 2000;24(9):1098-103. Khuroo MS, Khuroo NS, Khuroo MS.[revistagastrocol.com]
  • Conclusion There are several missing links in NLH, such as epidemiological data and non-invasive method to follow up such cases.[medresearch.in]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology of LNH GI mucosal lymphatic tissue consists of inductive and effector compartments [ 23 ].[abdominalkey.com]
  • Eosinophilic colitis: An update on pathophysiology and treatment. Br Med Bull. 2011;100:59-72. DOI: 10.1093/bmb/ldr045 [ Links ] 17. Jensens ET, Kappelman MD, Martin CF, Dellon ES.[scielo.org.mx]

Prevention

  • They’re also extremely helpful for preventing hyperplasia and reducing risk for cancer naturally.[draxe.com]
  • Although regular Ig replacement therapy reduces susceptibility to Giardia species and Campylobacter enteritis, it does not prevent autoimmune mucosal inflammation.[emedicine.medscape.com]
  • Monogr Eval Carcinog Risks Hum. 1994, 61: 1- Google Scholar Malfertheiner P, Sipponen P, Naumann M, Moayyedi P, Mégraud F, Xiao SD, Sugano K, Nyrén O, Lejondal, H. pylori-Gastric Cancer Task Force: Helicobacter pylori eradication has the potential to prevent[bmcgastroenterol.biomedcentral.com]

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