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Plasmacytic or lymphoplasmacytic infiltrate in lymph nodes: Diagnostic approach and differential considerations
Yi Xie1, Bethany Vallangeon1, Xin Liu1
1Department of Pathology, Duke University Medical Center, Durham, NC, USA.
Insights
Plasmacytosis in lymph nodes can indicate various conditions, from reactive changes to lymphoma. Accurate diagnosis requires understanding histopathologic features and clinical findings for effective patient management.
Area of Science:
- Surgical pathology
- Hematopathology
- Oncology
Background:
- Plasmacytosis is frequently observed in lymph node biopsies.
- It can be associated with reactive lymphadenopathy or malignant lymphoma.
- Distinguishing these entities is crucial for patient care.
Purpose of the Study:
- To review common nonneoplastic and neoplastic entities with plasmacytic differentiation in lymph nodes.
- To emphasize histological classification and diagnostic challenges.
- To provide an approach for accurate diagnosis.
Main Methods:
- Review of literature on lymph node biopsies with plasmacytosis.
- Focus on histopathologic features of various entities.
- Discussion of clinical and ancillary study findings.
Main Results:
- Common nonneoplastic conditions and lymphomas exhibiting plasmacytic differentiation were identified.
- Diagnostic criteria and challenging cases were highlighted.
- Histological classification was presented.
Conclusions:
- Accurate diagnosis of lymph node plasmacytosis relies on understanding histopathology and clinical context.
- Distinguishing reactive from neoplastic processes is essential.
- This review aids pathologists in diagnosing challenging cases.
Abstract:
Plasmacytosis is a common finding in lymph node biopsies and can be seen in diverse circumstances ranging from reactive lymphadenopathy to malignant lymphoma. Familiarity with various histopathologic features of the different entities and awareness of their typical clinical and ancillary study findings are essential for an accurate diagnosis. In this review, we present common and representative nonneoplastic entities and lymphomas that have plasmacytic differentiation or associated plasmacytosis. We focus on the histological classification with an emphasis on the diagnostic approach and areas of diagnostic challenge.
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