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[Mycobacterial spindle cell pseudotumor of lymph nodes]
1Department of Pathology, Nanjing General Hospital of PLA, Nanjing 210002, China. yinhl@jlonline.com
Insights
Mycobacterial spindle cell pseudotumor can affect infants post-Bacilli Calmette Guerin (BCG) vaccination, presenting as enlarged lymph nodes. Early recognition is crucial as it mimics tumors, requiring proper diagnosis and treatment.
Area of Science:
- Pathology
- Immunology
- Pediatrics
Context:
- Mycobacterial spindle cell pseudotumor is a rare condition.
- It can occur in lymph nodes, particularly in infants.
- Previous cases have been associated with immunodeficiency.
Purpose:
- To investigate the clinicopathological features of mycobacterial spindle cell pseudotumor in lymph nodes.
- To analyze two cases in infants following Bacilli Calmette Guerin (BCG) vaccination.
Summary:
- Two infant cases presented with fever and enlarged lymph nodes after BCG vaccination.
- Histopathology revealed spindle cell proliferation with Mycobacterium presence.
- Immunohistochemistry showed positive Mac387 and lysosome, negative S-100.
Impact:
- This condition can occur in non-immunodeficient infants after BCG vaccination.
- It may be misdiagnosed as a spindle cell tumor.
- Accurate identification is vital for appropriate patient management.
Objective:
To study the clinicopathological of mycobacterial spindle cell pseudotumor in lymph nodes.
Methods:
Two cases of spindle cell pseudotumor in the lymph nodes of infants were examined using light microscopy. The sections were stained with HE, Ziehl-Neelsen and studied immunohistochemically.
Results:
Both infants were 1 year of age and had a history of Bacilli Calmette Guerin (BCG) vaccination before discovery of their lymph node lesions. Clinically, the patients presented fever and enlarged lymph nodes. Histopathologically, the lesions showed proliferation of spindle cells arranged in bundles, storiform patterns with abundant capillaries and lymphocyte, plasma cell and neutrophil infiltration forming a spindle cell pseudotumor. Most of the spindle cells were phagocytic cells which contained large amounts of mycobactrium as observed by Ziehl-Neelsen staining. Immunohistochemical staining showed strongly positive result for Mac387 and lysosome, but negative for S-100 in spindle cells and histocytes.
Conclusions:
Mycobacterial spindle cell pseudotumor of lymph nodes may occur not only in immunodeficient patients (such as AIDS) but also in infants after BCG vaccination. The lesions may mimic spindle cell tumor in lymph nodes, therefore it is very important to recognize these lesions in order to treat the patient properly.