Presentation
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]
In conclusion, we present the first case of lymphoid polyposis from 6-year-old identical twins. [ispub.com]
It primarily affects children, and it is usually asymptomatic; however, it may present with abdominal pain, chronic diarrhea, bleeding, or intestinal obstruction[ 1, 4 ]. [e-sciencecentral.org]
In this case report, the complexity of the clinical presentations in CVID patients was stressed. [ijpmonline.org]
Patients may present with an ‘acute abdomen’, indistinguishable from acute appendicitis. Other presenting symptoms are anaemia, retardation of growth, anorexia and weight loss. [radiologykey.com]
Entire Body System
- Anemia
These patients were more likely to have increased frequencies of infections, hepatosplenomegaly, iridocyclitis, autoimmune hemolytic anemia, or immune thrombocytopenic purpura. [emedicine.medscape.com]
These include nodular lymphoid hyperplasia, which was reported in our case, inflammatory bowel disease (ulcerative colitis, ulcerative proctitis, or Crohn's disease), sprue-like illness with flat villi, pernicious anemia, giardiasis, and non-specific [ijpmonline.org]
Diffuse nodular lymphoid hyperplasia of intestine in selec- tive IgG 2 subclass deficiency, autoimmune thyroiditis, and autoimmune hemolytic anemia: case report and literature review. Journal of gastrointestinal and liver diseases. [revistagastrocol.com]
They suggest looking for risk factors in CVID patients, such as Helicobacter pylori infection, pernicious anemia, or dyspepsia, prior to initiating screening esophagogastroduodenoscopy (EGD). [acgcasereports.gi.org]
Diffuse nodular lymphoid hyperplasia of intestine in selective IgG 2 subclass deficiency, autoimmune thyroiditis, and autoimmune hemolytic anemia: case report and literature review. J Gastrointestin Liver Dis. 2012;21:431–4. PubMed 4. [springermedizin.at]
- 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]
- Asymptomatic
Nodular lymphoid hyperplasia may be associated with symptoms such as diarrhea and malabsorption in some patients, whereas other patients may be asymptomatic. [nejm.org]
It primarily affects children, and it is usually asymptomatic; however, it may present with abdominal pain, chronic diarrhea, bleeding, or intestinal obstruction[ 1, 4 ]. [e-sciencecentral.org]
Butterworths. 1983 Lymphoid hyperplasia “The last form of NLH is that restricted to the terminal ileum which has also been termed benign lymphoid hyperplasia due to the frequency of its demonstration in asymptomatic children. [briandeer.com]
[…] reports had described DNLH in adult patients without immunodeficiency and it was thought to be associated with chronic GIT infections such as Giardiasis or Helicobacter pylori infection. 4, 8, 10 Nodular lymphoid hyperplasia generally presents as an asymptomatic [medcraveonline.com]
Deep fissures frequent No fissures or deep ulcers Incidental Chronic Colitis Crohn Disease Isolated disease Usually multifocal Virtually restricted to cecum/right colon May involve entire GI tract No granulomas Granulomas may be present Incidental, asymptomatic [surgpathcriteria.stanford.edu]
- Developmental Disorder
Adds five new chapters including "Screening and Surveillance of the GI Tract", "Congenital and Developmental Disorders of the GI Tract", "Pediatric Enteropathies of the GI Tract", "Vascular Disorders of the GI Tract", and "Fatty Liver Disease". [books.google.com]
In February 1998, a worldwide scare was launched over the safety of the MMR children’s vaccine, with a paper in The Lancet by Andrew Wakefield and others, titled Ileal-lymphoid-nodular hyperplasia, non-specific colitis and pervasive developmental disorder [briandeer.com]
Respiratoric
- Pneumonia
Clinical findings Range from mild GI discomfort (in IgA deficiency) to severe malabsorption, chronic diarrhoea, recurrent bacterial infections with sinusitis, bronchitis, bronchiectasis, pneumonia (in CVID). [medical-dictionary.thefreedictionary.com]
Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae, and Staphylococcus aureus are the organisms most commonly involved. [emedicine.medscape.com]
There had not been any history of recurrent infections, such as sinusitis, bronchitis, pneumonia or otitis. [ijpmonline.org]
気管支肺炎:bronchopneumonia 大葉性肺炎:lobar pneumonia ◎ 肺結核 :pulmonary tuberculosis 初期変化群,浸出型,増殖型,粟粒結核(miliary tuberculosis), 結核腫(tuberculoma) ◎肺真菌感染症(アスペルギルス,カンジダ,クリプトコッカス,ムコール) ◎カリニ肺炎:pneumocystis carinii pneumonia 巨細胞肺炎:giant cell pneumonia(麻疹肺炎:measles pneumonia [medical-e.net]
(UIP)) 肺好酸球性肉芽腫(Pulmonary eosinophilic granuloma) ニューモシスチス肺炎(Pneumocystis jirovecii pneumonia) 逆流性食道炎(Reflux esophagitis) 食道乳頭腫(Squamous papilloma of the esophagus) 胃のMALTリンパ腫(Gastric MALT lymphoma) 胃腺癌(Gastric adenocarcinoma) 胃癌(腺癌)(Adenocarcinoma of [kinpodo-pub.co.jp]
Gastrointestinal
- Intestinal Disease
IGA CHILD INTESTINAL DISEASE HUMAN GASTROENTEROLOGY HEMATOLOGY Keyword (es) GASTROENTEROLOGIA HEMATOLOGIA Classification Pascal 002 Biological and medical sciences / 002B Medical sciences / 002B13 Gastroenterology. [pascal-francis.inist.fr]
Problems with the small intestine can include: Bleeding Celiac disease Crohn's disease Infections Intestinal cancer Intestinal obstruction Irritable bowel syndrome Ulcers, such as peptic ulcer Treatment of disorders of the small intestine depends on the [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]
- Payr's Syndrome
[…] coli Metaplastic polyposis of intestine Nodular lymphoid hyperplasia of intestine Oleogranuloma of intestine Payr's syndrome Pericolitis Perisigmoiditis Pneumatosis cystoides intestinalis Polyp of intestine Proctosigmoiditis Prolapse of intestine Pseudo-obstruction [emedcodes.com]
569.89 Stricture (see also Stenosis) 799.89 rectosigmoid 569.89 Suppuration, suppurative - see also condition bowel 569.89 intestine 569.89 Syndrome - see also Disease Glénard's (enteroptosis) 569.89 hepatic flexure 569.89 Payr's (splenic flexure syndrome [icd9data.com]
Cardiovascular
- Vascular Disease
In many conditions the underlying disease e.g. collagen vascular disease or inflammatory bowel disease is already known and the presence of increased eosinophils in the biopsies is less of a diagnostic issue. [uscapknowledgehub.org]
Musculoskeletal
- Fracture
Entrapment of intestine in pelvic fracture Entrapment of intestine in peritoneal defect Entrapment of intestine in spinal fracture Entrapment of intestine over renosplenic ligament Erythematous duodenopathy Fibrosing colonopathy Food granuloma of intestine [emedcodes.com]
He had traumatic fracture of his ribs many months ago for which he has been taking variety of pain killers including Acteoaminophen and Oxycodone. [uscapknowledgehub.org]
未熟奇形腫:immature teratoma 皮様嚢胞腫:dermoid cyst ◎卵巣甲状腺腫:struma ovarii ◎カルチノイド腫瘍:carcinoid tumor 線維腫:fibroma 腺線維腫:adenofibroma ◎Krukenberg腫瘍 運動器 1)骨 急性化膿性骨髄炎:acute suppurative osteomyelitis 慢性骨髄炎:chronic osteomyelitis 結核性骨髄炎:tuberculous osteomyelitis ◎骨折:bone fracture [medical-e.net]
Skin
- Erythema
[…] induratum 多形滲出性紅斑:erythema exudativum multiforme 天疱瘡 :pemphigus ◎ 類天疱瘡 :bullous pemphigoid 慢性単純性苔癬(ヴィダール苔癬):lichen simplex chronicus ◎扁平苔癬:lichen planus ◎全身性エリテマトーデス:systemic lupus erythematosus 慢性円盤状エリテマトーデス:discoid lupus erythemarosus 強皮症:scleroderma [medical-e.net]
Neurologic
- Personality Change
Presenting symptoms are either acute or insidious, with signs of encephalitis, seizures, headache, sensory motor disturbances, and personality changes. [emedicine.medscape.com]
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]
Microbiology
- Giardia Lamblia
It is associated with immunodeficiency and infection, such as Giardia lamblia and Helicobacter pylori. [ncbi.nlm.nih.gov]
Examination of the stool revealed trophozoites of the species Giardia lamblia. She underwent gastroduodenoscopy, which revealed numerous nodules in the duodenum (Panel A). [nejm.org]
Although gastric achlorhydria (two patients), minimal to moderate pancreatic insufficiency (two patients), significant intestinal intraluminal bacterial overgrowth (three patients), and Giardia lamblia (five patients) were found, the evidence suggests [annals.org]
Giardia lamblia cysts are present in the stools of most of these patients with the syndrome of dysgammaglobulinemia, nodular lymphoid hyperplasia, recurrent respiratory and urinary tract infections, chronic sprue-like diarrhea, and other clinical and [isradiology.org]
Microscopic examination of the feces didn’t reveal Giardia lamblia. Chest X-ray showed bilateral bronchiectases predominant in the lower lobes and on the right side. [latunisiemedicale.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]
- Staphylococcus Aureus
Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae, and Staphylococcus aureus are the organisms most commonly involved. [emedicine.medscape.com]
- Streptococcus Pneumoniae
Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae, and Staphylococcus aureus are the organisms most commonly involved. [emedicine.medscape.com]
Colonoscopy
- Polyps
Abstract Three patients with multiple lymphoid polyps of the small intestine--two with nodular lymphoid hyperplasia and one with multiple lymphomatous polyposis--developed high-grade B-cell lymphomas. [ncbi.nlm.nih.gov]
Grossly, the specimens were multiple pink to brown oval to cylindrical polyps ranging from 0.3 to 1 cm in the greatest dimension. [ispub.com]
Histologically mucosa of the resected colon showed diffuse multiple hyperplastic nodules with infrequent metaplastic polyps less than 5 mm in diameter. [webview.isho.jp]
Solitary Rectal Ulcer) Crohn Disease Shallow ulceration Deep ulcers and fissures Restricted to rectum (rarely in sigmoid) May involve any part of GI tract Not concentric, usually localized to anterior rectal wall Usually concentric Frequently forms a polyp [surgpathcriteria.stanford.edu]
Definition / general Also called lymphoid polyp; formerly called pseudolymphoma Most common site is ileocecal region Causes intussusception in children Nodular lymphoid hyperplasia: nodules throughout bowel, associated with giardiasis or childhood viral [pathologyoutlines.com]
Other Pathologies
- Lymph Node Hyperplasia
[…] i.e., histiocytosis X and metastatic carcinoma can involve lymph nodes causing a reactive hyperplasia or mimic a hyperplasia (Histiocytosis X in the sinuses of a lymph node) and thus need to be carefully ruled out on microscopic exam. [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]
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]
The patient’s diarrhea abated with metronidazole treatment; she was counseled about the risk of infection associated with common variable immunodeficiency. [nejm.org]
On the contrary lymphoid hyperplasia was strikingly either absent or very modest in children with Crohn's disease on steroid treatment but also some cases before starting treatment. [crohnsforum.com]
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]
It usually runs a benign and self-limiting course in children whereas in adults the prognosis is uncertain [6]. [medresearch.in]
Saltzstein SL (1963) Pulmonary Malignant Lymphomas and Pseudolymphomas: Classification, Therapy, and Prognosis. Cancer 16: 928-955. [pancreas.imedpub.com]
Etiology
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]
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]
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]
Epidemiology. 2008; 19: 71-74. doi. 10.1097/EDE.0b013e31815c1dd3 Coulibaly B, et al. Benign lymphoid polyposis: two diffuse cases leading to fatal intestinal ischemia in children. [medigraphic.com]
Conclusion There are several missing links in NLH, such as epidemiological data and non-invasive method to follow up such cases. [medresearch.in]
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]