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Related Experiment Videos

Lymph node pathology in Henoch-Schönlein purpura.

A B Akosa1, M H Ali

  • 1Department of Histopathology, Wexham Park Hospital, Slough, UK.

Histopathology
|September 1, 1989
PubMed
Summary

Henoch-Schönlein purpura can present with abdominal pain and unusual lymph node findings. Histology revealed granulomas and vasculitis, supporting IgA deposition in Henoch-Schönlein purpura diagnosis.

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Area of Science:

  • Pediatric Rheumatology
  • Gastroenterology
  • Pathology

Background:

  • Henoch-Schönlein purpura (HSP) is a common childhood vasculitis.
  • Abdominal pain is a frequent symptom, often mimicking surgical emergencies.
  • Unusual lymph node pathology in HSP is rarely reported.

Observation:

  • Two pediatric cases presented with severe colicky abdominal pain, leading to appendectomies with normal appendices.
  • Enlarged mesenteric lymph nodes were surgically removed due to suspicion of Yersinia infection.
  • Microscopic examination revealed follicular granulomas, microabscesses, and leucocytoclastic vasculitis in lymph nodes.

Findings:

  • Immunohistochemistry demonstrated IgA, IgG, and C3 deposition in lymph node vessel walls.
  • IgA deposition strongly supported the diagnosis of Henoch-Schönlein purpura.
  • Cultures and serology for Yersinia infection were negative.

Implications:

  • This report highlights atypical lymph node findings in Henoch-Schönlein purpura.
  • It suggests considering HSP in pediatric patients with abdominal pain and mesenteric lymphadenopathy.
  • Understanding these pathological features aids in accurate diagnosis and management of HSP.

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