Abstract
A 16-month-old boy presented with cervical lymphadenopathy and a mediastinal mass causing tracheal displacement. Treatment of what at first was suspected to be a malignant neoplasm was limited to low-dose irradiation of the mediastinum and biopsy excision of the cervical lymph nodes. There has been no recurrence of disease in the subsequent four years.
The pathological features and clinical course correspond to a benign disease first described in 1969 in which there is massive proliferation of histiocytes in lymph node sinuses. No infectious cause was identified. Consistent but eventually reversible defects in lymphocyte response to phytohaemagglutinin and in augmentation of nitro-blue tetrazolium reduction by neutrophils during phagocytosis were demonstrated in the patient and in his monozygous twin. These defects in cellular immune function are believed to be important in the pathogenesis of the histiocytosis.
Full text
PDF![463](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecc8/477797/c4161a7f2fd3/jclinpath00117-0001.png)
![464](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecc8/477797/838c18208c3c/jclinpath00117-0002.png)
![465](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecc8/477797/55f22aab0518/jclinpath00117-0003.png)
![466](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecc8/477797/f36ec14b4196/jclinpath00117-0004.png)
![467](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecc8/477797/1c4833204b4d/jclinpath00117-0005.png)
![468](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecc8/477797/a0d47312f3ae/jclinpath00117-0006.png)
![469](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecc8/477797/b37bffcfb198/jclinpath00117-0007.png)
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Baehner R. L., Nathan D. G. Quantitative nitroblue tetrazolium test in chronic granulomatous disease. N Engl J Med. 1968 May 2;278(18):971–976. doi: 10.1056/NEJM196805022781801. [DOI] [PubMed] [Google Scholar]
- Becroft D. M., Douglas R. Thymic alymphoplasia, monoclonal gammopathy, and Pneumocystis carinii pneumonia in an infant. Arch Dis Child. 1968 Aug;43(230):444–450. doi: 10.1136/adc.43.230.444. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Berard C. W., Cooper R. A., Freireich E. J., Rabson A. S. Disseminated histiocytosis associated with atypical lymphoid cells (lymphohistiocytosis). Cancer. 1966 Oct;19(10):1429–1437. doi: 10.1002/1097-0142(196610)19:10<1429::aid-cncr2820191016>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
- CARSON M. J., CHADWICK D. L., BRUBAKER C. A., CLELAND R. S., LANDING B. H. THIRTEEN BOYS WITH PROGRESSIVE SEPTIC GRANULOMATOSIS. Pediatrics. 1965 Mar;35:405–412. [PubMed] [Google Scholar]
- Claman H. N., Suvatte V., Githens J. H., Hathaway W. E. Histiocytic reaction in dysgammaglobulinemia and congenital rubella. Pediatrics. 1970 Jul;46(1):89–96. [PubMed] [Google Scholar]
- DeMeo A. N., Andersen B. R. Defective chemotaxis associated with a serum inhibitor in cirrhotic patients. N Engl J Med. 1972 Apr 6;286(14):735–740. doi: 10.1056/NEJM197204062861401. [DOI] [PubMed] [Google Scholar]
- Douglas S. D., Lahav M., Fudenberg H. H. A reversible neutrophil bactericidal defect associated with a mixed cryoglobulin. Am J Med. 1970 Aug;49(2):274–280. doi: 10.1016/s0002-9343(70)80085-7. [DOI] [PubMed] [Google Scholar]
- Fitzgerald M. G. A satisfactory quantitative test of lymphocyte response to phytohaemagglutinin for the definition of normal control values and recognition of immunological defects. J Clin Pathol. 1972 Feb;25(2):163–168. doi: 10.1136/jcp.25.2.163. [DOI] [PMC free article] [PubMed] [Google Scholar]
- HARRIS H. Chemotaxis of granulocytes. J Pathol Bacteriol. 1953 Jul;66(1):135–146. doi: 10.1002/path.1700660117. [DOI] [PubMed] [Google Scholar]
- Hicks R. G., Bennett J. M. Am improved cytochemical method for nitroblue tetra-zolium reduction by neutrophils. Am J Med Technol. 1971 Jun;37(6):226–229. [PubMed] [Google Scholar]
- Kretschmer R. R., Lopez Osuna M., Valenzuela R. H. Reversible neutrophil defect in ataxia telangiectasia. Pediatrics. 1972 Jul;50(1):147–150. [PubMed] [Google Scholar]
- McCracken G. H., Jr, Weinberg A. G., Carlin M. E. Granulomatous lung disease with progressive deterioration of phagocytic function. J Pediatr. 1972 Aug;81(2):267–274. doi: 10.1016/s0022-3476(72)80294-4. [DOI] [PubMed] [Google Scholar]
- Rosai J., Dorfman R. F. Sinus histiocytosis with massive lymphadenopathy. A newly recognized benign clinicopathological entity. Arch Pathol. 1969 Jan;87(1):63–70. [PubMed] [Google Scholar]
- Rosai J., Dorfman R. F. Sinus histiocytosis with massive lymphadenopathy: a pseudolymphomatous benign disorder. Analysis of 34 cases. Cancer. 1972 Nov;30(5):1174–1188. doi: 10.1002/1097-0142(197211)30:5<1174::aid-cncr2820300507>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]