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By Dennis H. Wright B.Sc, M.D., F.R.C.Path., Peter G. Isaacson D.M., M.R.C.Path. (auth.)

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9) are usually small and multiple and whilst they efface much of the normal nodal tissue, tend to remain discrete, not fusing into larger lesions as occurs in tuberculosis; multinucleated giant cells are also not as frequent and there is often considerable fibrosis araund the granulomas. Necrosis of sarcoid granulomas occurs infrequently (Fig. 10). The mesenteric lymph node granulomas in Crohn's disease vary from small epithelioid cell clusters to multiple well-formed epithelioid granulomas with central multinucleated giant cells.

Fig. 6 An example of the plasma cell type of angiofollicular hyperplasia stained by the immunoperoxidase technique for kappalight chain (a) and Iambda chain (b). The presence of a mixture of cells producing both light chains indicates a polyclonal, non-neoplastic plasma cell infiltrate, x 100. : -... ~.. ,, . I ' • ',& ' (b) . ,,. :. 1 Histiocytosis X presenting with lymphadenopathy Synonyms: Eosinophilic granuloma of lymph nodes Hand-Schuller-Christian disease Letterer-Siwe disease The clinical spectrum of histiocytosis X as it affects the lymphoreticular system is weil reviewed by Williams and Dorfman (1979).

Photograph by courtesy of Dr Carmen Rivas, Madrid, x 4200. Fig. 8 Histiocytosis X. The sinuses of this lymph node are distended by an infiltrate of histiocytes amongst which multinucleated cells are evident, x 30.

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