Whipple Disease

Related Cases: HP-302

  • Associated with infection by Tropheryma whippelii
  • Mostly middle-aged men, symptoms of weight loss, diarrhea, abdominal pain, and arthralgia
  • Usually abdominal lymphadenopathy, 50% peripheral or mediastinal lymphadenopathy
  • Histology:
    • Markedly dilated sinuses
    • Large, pale-staining, finely vacuolated histiocytes
    • Large cystic vacuoles
    • Occasionally non-necrotizing granulomas
  • Special staining: PAS+, AFB-
  • Electron microscopy confirms the presence of bacteria
  • PCR detection of T. whippelii in fixed tissues
  • DDX: lymphangiogram effect, Mycobacterium avium-intracellulare, sarcoidosis, and leprosy

Last updated: 05/19/2015