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15 December 2007

Toxoplasmic lymphadenitis clinically and histologically simulating a lymphoma

Debdatta Basu, Rajiv Subramanian, I. Akash, Tarun Kumar Dutta

Case Rep Clin Pract Rev 2007; 8:331-333 :: ID: 598953

Abstract

Background: Toxoplasmic lymphadenitis may be mistaken, both clinically and histologically for granulomatous lymphadenitis, especially in areas with high prevalence of tuberculosis. It can also be clinically mistaken for lymphomas.
Case Report: We report a case of a young male who presented with fever and generalized lymphadenopathy. The clinical suspicion was that of Hodgkin lymphoma. The lymph node biopsy showed partial effacement of architecture with focal follicular hyperplasia, few small clusters of epithelioid cells and increased high-endothelial venules. However no caseation necrosis, giant cells, infi ltration by eosinophils, plasma cells or Reed-Sternberg cells were noted. A few atypical mononuclear histiocytes were seen in the paracortical area. The features were suspicious but not diagnostic of either Hodgkin lymphoma or tuberculosis. A second biopsy was advised which showed characteristic microscopic features of toxoplasmic lymphadenitis. This was confi rmed on serology.
Conclusions: A strong clinical suspicion coupled with characteristic histological features and serology is necessary for an accurate diagnosis of Toxoplasmic lymphadenitis.

Keywords: Hodgkin Disease, Toxoplasmosis, lymphadenopathy, microgranulomas, Tuberculosis

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923