Dermatopathic lymphadenitis. The spectrum and significance of its morphologic features

The lymph nodes from 50 axillary node dissections were evaluated by light microscopy and immunohistochemistry for the presence of dermatopathic lymphadenitis-like histologic features. On the basis of hematoxylin-eosin-stained sections alone, a histologic continuum was observed ranging from minimal paracortical changes to fully developed dermatopathic lymphadenitis. Twenty-three lymph node biopsies previously interpreted as diagnostic of dermatopathic lymphadenitis were reviewed. Only nine of these showed the fully developed dermatopathic lymphadenitis. Only one of these patients had a dermatitis. Our conclusions are that the presence of dermatopathic lymphadenitis does not mean that the patient has concomitant skin disease, and that axillary lymph nodes from patients without skin disease manifest a spectrum of dermatopathic lymphadenitis-like histologic features. Dermatopathic lymphadenitis may represent one end of a normally occurring histologic spectrum that may be found in the absence of a dermatitis.