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Related Experiment Videos

Histiocytic lymphadenitis associated with a large joint prosthesis

J X O'Connell1, A E Rosenberg

  • 1Department of Pathology, Massachusetts General Hospital, Boston 02114.

American Journal of Clinical Pathology
|March 1, 1993
PubMed
Summary

Microscopic examination of lymph nodes revealed polyethylene particles from a shoulder joint replacement. This indicated reactive lymphadenopathy, an uncommon finding near prosthetic joints.

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Area of Science:

  • Orthopedic pathology
  • Surgical pathology
  • Immunohistochemistry

Background:

  • Modified radical mastectomy involves lymph node removal.
  • Total shoulder joint replacements can have long-term complications.
  • Reactive lymphadenopathy is a non-specific immune response.

Observation:

  • Enlarged axillary lymph nodes were examined microscopically.
  • Macrophages with granular eosinophilic cytoplasm were noted in lymph node sinuses.
  • Presence of birefringent particles was observed under polarization microscopy.

Findings:

  • Periodic acid-Schiff staining confirmed the presence of carbohydrates.
  • Polarization microscopy identified polyethylene particles within macrophages.
  • These findings are diagnostic of reactive lymphadenopathy secondary to a joint prosthesis.

Implications:

  • Highlights the importance of considering prosthetic material in lymph node pathology.
  • Suggests potential for subclinical particle migration from joint prostheses.
  • Underscores the need for careful histological interpretation in patients with prior orthopedic surgery.

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