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Case 195 - Discussion

Hematopathology Case

 

Toxoplasmic Lymphadenitis

  • Toxoplasma gondii

  • Immunocompetent patients mostly present as solitary  posterior cervical lymphadenopathy

  • Self-limited, but severe complications in immunodeficient patients

  • Histology:

  • Florid follicular hyperplasia

  • Interfollicular epithelioid histiocytes, singly or in small clusters; may encroach on or present in germinal centers

  • Monocytoid B cells in a sinusoidal and parasinusoidal pattern

  • Usually lack of necrosis or well-formed granulomas

  • Cysts/intracellular organisms only rarely found

  • DDX: Leishmania lymphadenitis; early stages of cat-scratch disease, infectious mononucleosis, and CMV lymphadenitis