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Created page with "__NOTOC__ {{SI}} {{CMG}}; {{AE}} {{SC}} {{MV}} {{SK}} Brenner tumor of ovary; Brenner tumor of the ovary; Transitional cell tumour of the ovary; Ovarian transitional cell t..."
 
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__NOTOC__
__NOTOC__
{{SI}}
{{SI}}                                                                  
 
{{CMG}} {{AE}} {{MV}}
{{CMG}}; {{AE}} {{SC}} {{MV}}
 
{{SK}} Synonym 1; Synonym 2; Synonym 3
{{SK}} Brenner tumor of ovary; Brenner tumor of the ovary; Transitional cell tumour of the ovary;  Ovarian transitional cell tumour
   
 
==Overview==
==Overview==
Brenner tumors are an uncommon subtype of the [[surface epithelial-stromal tumor]] group of [[Ovarian cancer|ovarian neoplasm]]s. The majority are [[benign]], but some can be [[malignant]].
They are most frequently found incidentally on [[pelvic examination]] or at [[laparotomy]]. Brenner tumours very rarely can occur in other locations, including the [[testes]].<ref name=wikipedia>Brenner tumor. Wikipedia 2015. https://en.wikipedia.org/wiki/Brenner_tumour</ref>


==Historical Perspective==
'''Lymphadenopathy''' ( in Greek, ''adenas'' ("gland") and  ''patheia'' ("act of suffering" or "disease") ) refers to [[lymph nodes]] which are abnormal in size, number or consistency  and is often used as a synonym for swollen or enlarged lymph nodes.  Common causes of lymphadenopathy are [[infection]], [[autoimmune]] disease, or [[malignancy]].
Brenner tumor was first described in 1907 by Fritz Brenner. The term "Brenner tumor" was first used by Robert Meyer, in 1932.<ref name=wikipedia>Brenner tumor. Wikipedia 2015. https://en.wikipedia.org/wiki/Brenner_tumour</ref>


==Classification==
==Classification==
 
*[Disease name] may be classified according to [classification method] into [number] subtypes/groups:
:*[group1]
:*[group2]
:*[group3]
*Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].
==Pathophysiology==
==Pathophysiology==
===Pathogenesis===
*The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
90% of Brenner tumors are unilateral (arising in one ovary, the other is unaffected). The tumors can vary in size from less than 1cm to 30cm. Borderline and malignant Brenner tumours are possible but each are rare.<ref name=wikipedia>Brenner tumor. Wikipedia 2015. https://en.wikipedia.org/wiki/Brenner_tumour</ref>
*The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
*On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
*On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
==Causes==
* [Disease name] may be caused by either [cause1], [cause2], or [cause3].
* [Disease name] is caused by a mutation in the [gene1], [gene2], or [gene3] gene[s].
* There are no established causes for [disease name].
==Differentiating [disease name] from other Diseases==
*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
:*[Differential dx1]
:*[Differential dx2]
:*[Differential dx3]
 
==Risk Factors==
*Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].


May arise from the fallopian tube.
Can be seen in the testis.
== Diagnosis ==
Thought to arise from Walthard cell rest.
===Diagnostic Criteria===
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
:*[criterion 1]
:*[criterion 2]
:*[criterion 3]
:*[criterion 4]
=== Symptoms ===
*[Disease name] is usually asymptomatic.
*Symptoms of [disease name] may include the following:
:*[symptom 1]
:*[symptom 2]
:*[symptom 3]
:*[symptom 4]
:*[symptom 5]
:*[symptom 6]
=== Physical Examination ===
*Patients with [disease name] usually appear [general appearance].
*Physical examination may be remarkable for:
:*[finding 1]
:*[finding 2]
:*[finding 3]
:*[finding 4]
:*[finding 5]
:*[finding 6]
=== Laboratory Findings ===
*There are no specific laboratory findings associated with [disease name].


===Genetics===
*A  [positive/negative] [test name] is diagnostic of [disease name].
*An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
*Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
===Imaging Findings===
*There are no [imaging study] findings associated with [disease name].
*[Imaging study 1] is the imaging modality of choice for [disease name].
*On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
*[Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
=== Other Diagnostic Studies ===
*[Disease name] may also be diagnosed using [diagnostic study name].
*Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
== Treatment ==
=== Medical Therapy ===


===Gross pathology===
On gross pathology, a solid, well-circumscribed, and light yellow [[mass]] is the characteristic finding of Brenner tumor.<ref name=libre>Brenner tumor. Librepathology 2015. http://librepathology.org/wiki/index.php/Brenner_tumour</ref>
=== Surgery ===


* Solid, well-circumscribed, light yellow mass
==References==
* May be cystic
{{Reflist|2}}
[[Category: Oncology]]


====Gallery====
<gallery>
Image:
Brenner_tumor1.jpg|Brenner tumor<ref name=wikipedia>Brenner tumor. Wikipedia 2015. https://en.wikipedia.org/wiki/Brenner_tumour</ref>
</gallery>


===Microscopic Pathology===
On microscopic histopathological analysis, nests of transitional epithelium cells, coffee bean nucleus, and dense fibrous stroma around nests are characteristic findings of Brenner tumor.<ref name=libre>Brenner tumor. Librepathology 2015. http://librepathology.org/wiki/index.php/Brenner_tumour</ref>


* Nests of transitional epithelium cells<ref name=libre>Brenner tumor. Librepathology 2015. http://librepathology.org/wiki/index.php/Brenner_tumour</ref>
:* A "coffee bean nucleus"
::* Elliptical shape
::* Nuclear grooves
::* Distinct nucleoli
::* Moderate-to-abundant gray or pale cytoplasm
* Dense fibrous stroma around nests


====Gallery====
<gallery>
Image:
Brenner_tumor2.jpg|Brenner tumor<ref name=libre>Brenner tumor. Librepathology 2015. http://librepathology.org/wiki/index.php/Brenner_tumour</ref>
</gallery>


==Causes==


==Differentiating Brenner tumor from other Diseases==
Brenner tumor must be differentiated from ovarian fibroma and thecoma.
* Ovarian fibroma
* Ovarian fibrothecoma
* Pedunculated leiomyoma


==Epidemiology and Demographics==
===Prevalence===
Brenner tumours account for up to 3.2% of ovarian epithelial neoplasms.


===Incidence===
{{Infobox symptom |
  Name          = Lymphadenopathy |
  Image          = Lymphadanopathy.JPG|
  Caption        = Neck lymphadenopathy associated with [[infectious mononucleosis]]|
Field          = [[Infectious disease (medical specialty)|Infectious disease]]|


===Age===
  ICD10          = {{ICD10|I|88||i|80}}, {{ICD10|L|04||l|00}}, {{ICD10|R|59|1|r|50}} |
Most often found incidentally in women between their 5th and 7th decades of life.
  ICD9          = {{ICD9|289.1}}-{{ICD9|289.3}}, {{ICD9|683}}, {{ICD9|785.6}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = 001301 |
  eMedicineSubj  = ped |
  eMedicineTopic = 1333 |
  DiseasesDB    = 22225 |
  MeshID        = D008206 |
}}


===Gender===
'''Lymphadenopathy''' or '''lymphadenitis''' refers to [[lymph nodes]] which are abnormal in size, number or consistency <ref>{{cite journal|last=King|first=D|last2=Ramachandra|first2=J|last3=Yeomanson|first3=D|title=Lymphadenopathy in children: refer or reassure?|journal=Archives of Disease in Childhood: Education and Practice Edition|date=2 January 2014|pmid=24385291|doi=10.1136/archdischild-2013-304443|volume=99|pages=101–110}}</ref>  and is often used as a synonym for swollen or enlarged lymph nodes. Common causes of lymphadenopathy are [[infection]], [[autoimmune]] disease, or [[malignancy]].


==Risk Factors==
Inflammation as a cause of lymph node enlargement is known as lymphadenitis.<ref>{{DorlandsDict|five/000061907|lymphadenitis}}</ref> In practice, the distinction between lymphadenopathy and lymphadenitis is rarely made. Inflammation of the [[lymphatic vessels]] is also known as [[lymphangitis]].<ref>{{DorlandsDict|five/000061959|lymphangitis}}</ref> Infectious lymphadenitides affecting lymph nodes in the neck are often called [[Tuberculous cervical lymphadenitis|scrofula]].


==Screening==
The term comes from the word [[lymph]] and a combination of the Greek words {{lang|el|αδένας}}, ''adenas'' ("gland") and {{lang|el|παθεία}}, ''patheia'' ("act of suffering" or "disease").


==Natural history, Complications, and Prognosis==
Due to its peculiar high incidence, the presence of lymphadenopathy is a particularly important sign on the diagnosis of [[#HIV acute infection|HIV]] or even, untreated later stages of the infection, [[AIDS]].
===Natural history===
* Mostly benign clinical course.
* May be malignant - rarely (~1% of Brenner tumours).
* Approximately 6-7% of Brenner tumours can be bilateral.
* They can very rarely can occur in other locations, including the testis.
* Tumours are usually small (< 2cm).  Even with the occasional large tumour (> 10 cm), there is often a lack of local invasion, lymphadenopathy, ascites, or metastases (i.e. peritoneal metastases and omental caking) which help distinguish it from other malignant ovarian neoplasms.


===Complications===
==Types==
[[File:Dermatopathic lymphadenopathy - low mag.jpg|thumb|[[Micrograph]] of [[dermatopathic lymphadenopathy]], a type of lymphadenopathy. [[H&E stain]].]]
* '''Localized lymphadenopathy''': due to localized spot of infection e.g., an infected spot on the scalp will cause lymph nodes in the neck on that same side to swell up
* [[Generalized lymphadenopathy]]: due to a systemic infection of the body e.g., influenza or secondary [[syphilis]]
** [[Persistent generalized lymphadenopathy]] (PGL): persisting for a long time, possibly without an apparent cause
* [[Dermatopathic lymphadenopathy]]: lymphadenopathy associated with skin disease.


===Prognosis===
==Causes==
 
Lymph node enlargement is recognized as a common sign of infectious, autoimmune, or malignant disease. Examples may include:
==Diagnosis==
* Reactive: acute [[infection]] (''e.g.,'' [[bacterial]], or [[virus|viral]]), or chronic infections ([[tuberculous lymphadenitis]],<ref>{{cite journal |last1=Fontanilla |first1=JM|last2=Barnes|first2=A|last3=Von Reyn|first3=CF|title=Current diagnosis and management of peripheral tuberculous lymphadenitis|journal=Clinical Infectious Diseases|volume=53 |issue=6 |pages=555–562 |date=September 2011|pmid=21865192|doi=10.1093/cid/cir454}}</ref> [[cat-scratch disease]]<ref>{{cite journal |last1=Klotz |first1=SA|last2=Ianas|first2=V|last3=Elliott|first3=SP|title=Cat-scratch Disease|journal=American Family Physician|volume=83 |issue=2 |pages=152–155 |year=2011|pmid=21243990|url=http://www.aafp.org/afp/2011/0115/p152.html}}</ref>).
===Staging===
** The most distinctive sign of [[bubonic plague]] is extreme swelling of one or more lymph nodes that bulge out of the skin as "buboes." The buboes often become [[Necrosis|necrotic]] and may even rupture.<ref>{{cite journal |last1=Butler |first1=T|title=Plague into the 21st century|journal=Clinical Infectious Diseases|volume=49 |issue=5 |pages=736–742 |year=2009|pmid=19606935|doi=10.1086/604718}}</ref>
===History and Symptoms===
** [[Infectious mononucleosis]] is an acute viral infection caused by [[Epstein-Barr virus]] and may be characterized by a marked enlargement of the [[cervical lymph nodes]].<ref name="Benign lymphadenopathy"/>
They are most frequently found incidentally on pelvic examination or at laparotomy.
** It is also a sign of [[cutaneous anthrax]]<ref>{{cite journal |last1=Sweeney |first1=DA|last2=Hicks|first2=CW|last3=Cui|first3=X|last4=Li|first4=Y|last5=Eichacker|first5=PQ|title=Anthrax infection|journal=American Journal of Respiratory and Critical Care Medicine|volume=184 |issue=12 |pages=1333–1341 |date=December 2011|pmid=21852539|doi=10.1164/rccm.201102-0209CI |pmc=3361358}}</ref> and [[African trypanosomiasis|Human African trypanosomiasis]]<ref>{{cite journal |last1=Kennedy |first1=PG|title=Clinical features, diagnosis, and treatment of human African trypanosomiasis (sleeping sickness)|journal=Lancet Neurology|volume=12 |issue=2 |pages=186–194 |date=February 2013|pmid=23260189|doi=10.1016/S1474-4422(12)70296-X}}</ref>
**[[Toxoplasmosis]], a [[parasitic disease]], gives a generalized lymphadenopathy (''Piringer-Kuchinka lymphadenopathy'').<ref name=Status/>
**[[Castleman's disease|Plasma cell variant of Castleman's disease]] - associated with [[HHV-8]] infection and [[Human Immunodeficiency Virus|HIV]] infection<ref>{{cite journal |last1=Kim |first1=TU|last2=Kim|first2=S|last3=Lee|first3=JW|last4=Lee|first4=NK|last5=Jeon|first5=UB|last6=Ha|first6=HG|last7=Shin|first7=DH|title=Plasma cell type of Castleman's disease involving renal parenchyma and sinus with cardiac tamponade: case report and literature review|journal=Korean Journal of Radiology|volume=13 |issue=5 |pages=658–663 |date=September–October 2012|pmid=22977337|doi=10.3348/kjr.2012.13.5.658 |pmc=3435867}}</ref><ref>{{cite journal |last1=Zhang |first1=H|last2=Wang|first2=R|last3=Wang|first3=H|last4=Xu|first4=Y|last5=Chen|first5=J|title=Membranoproliferative glomerulonephritis in Castleman's disease: a systematic review of the literature and 2 case reports|journal=Internal Medicine (Tokyo, Japan)|volume=51 |issue=12 |pages=1537–1542 |date=June 2012|pmid=22728487|doi=10.2169/internalmedicine.51.6298}}</ref>
** [[Mesenteric lymphadenitis]] after viral systemic infection (particularly in the [[Gut-associated lymphoid tissue|GALT]] in the appendix) can commonly present like [[appendicitis]].<ref>{{cite journal |last1=Bratucu |first1=E|last2=Lazar|first2=A|last3=Marincaş|first3=M|last4=Daha|first4=C|last5=Zurac|first5=S|title=Aseptic mesenteric lymph node abscesses. In search of an answer. A new entity?|journal=Chirurgia (Bucarest, Romania: 1990)|volume=108 |issue=2 |pages=152–160 |date=March–April 2013|pmid=23618562|url=http://revistachirurgia.ro/pdfs/2013-2-152.pdf}}</ref><ref>{{cite journal |last1=Leung |first1=A|last2=Sigalet|first2=DL|title=Acute Abdominal Pain in Children|journal=American Family Physician|volume=67 |issue=11 |pages=2321–2327 |date=June 2003|url=http://www.aafp.org/afp/2003/0601/p2321.html}}</ref>
Less common infectious causes of lymphadenopathy may include bacterial infections such as [[cat scratch disease]], [[tularemia]], [[brucellosis]], or [[prevotella]].{{citation needed|date=January 2014}}


===Physical Examination===
* [[Tumoral]]:
===Laboratory Findings===
** Primary: [[Hodgkin lymphoma]]<ref>{{cite journal |last1=Glass |first1=C|title=Role of the Primary Care Physician in Hodgkin Lymphoma|journal=American Family Physician|volume=78 |issue=5 |pages=615–622 |date=September 2008|url=http://www.aafp.org/afp/2008/0901/p615.html |pmid=18788239}}</ref> and [[non-Hodgkin lymphoma]] give lymphadenopathy in all or a few lymph nodes.<ref name=Status>Status and anamnesis, Anders Albinsson. Page 12</ref>
===X Ray===
** Secondary: [[metastasis]], [[Virchow's Node]], [[neuroblastoma]],<ref>{{cite journal |last1=Colon|first1=NC|last2=Chung|first2=DH|title=Neuroblastoma|journal=Advances in Pediatrics|volume=58 |issue=1 |pages=297–311 |year=2011|pmid=21736987|doi=10.1016/j.yapd.2011.03.011 |pmc=3668791}}</ref> and [[chronic lymphocytic leukemia]].<ref>{{cite journal |last1=Sagatys|first1=EM|last2=Zhang|first2=L|title=Clinical and laboratory prognostic indicators in chronic lymphocytic leukemia|journal=Cancer Control|volume=19 |issue=1 |pages=18–25|date=January 2011|pmid=22143059|doi=}}</ref>
===CT===
* [[Autoimmune]] etiology: [[systemic lupus erythematosus]]<ref>{{cite journal |last1=Melikoglu |first1=MA|last2=Melikoglu|first2=M|title=The clinical importance of lymphadenopathy in systemic lupus erythematosus|journal=Acta Reumatologia Portuguesa|volume=33 |issue=4 |pages=402–406 |date=October–December 2008|pmid=19107085|url=http://www.actareumatologica.pt/oldsite/conteudo/pdfs/ARP_2008_4_402_07__AR_-_Lymphadenopathy.pdf}}</ref> and [[rheumatoid arthritis]] may have a generalized lymphadenopathy.<ref name=Status/>
* Immunocompromised etiology: [[AIDS]]. Generalized lymphadenopathy is an early sign of infection with [[human immunodeficiency virus]] (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS).<ref>{{cite journal |last1=Lederman |first1=MM|last2=Margolis|first2=L|title=The lymph node in HIV pathogenesis|journal=Seminars in Immunology|volume=20 |issue=3 |pages=187–195 |date=June 2008|pmid=18620868|doi=10.1016/j.smim.2008.06.001 |pmc=2577760}}</ref>  "Lymphadenopathy syndrome" has been used to describe the first symptomatic stage of [[HIV]] progression, preceding a diagnosis of AIDS.
* Bites from certain venomous snakes such as the [[pit viper]]<ref>{{cite journal |last1=Quan|first1=D|title=North American poisonous bites and stings|journal= [[Critical Care Clinics]] |volume=28 |issue=4 |pages=633–659 |date=October 2012|pmid=22998994|doi=10.1016/j.ccc.2012.07.010}}</ref>
* Unknown etiology: [[Kikuchi disease]],<ref>{{cite journal |last1=Komagamine |first1=T|last2=Nagashima|first2=T|last3=Kojima|first3=M|last4=Kokubun|first4=N|last5=Nakamura|first5=T|last6=Hashimoto|first6=K|last7=Kimoto|first7=K|last8=Hirata|first8=K|title=Recurrent aseptic meningitis in association with Kikuchi-Fujimoto disease: case report and literature review|journal=BMC Neurology|volume=12 |pages=187–195 |date=September 2012|pmid=23020225|doi= 10.1186/1471-2377-12-112 |pmc=3570427}}</ref> [[progressive transformation of germinal centers]], [[sarcoidosis]], [[Castleman's disease|hyaline-vascular variant of Castleman's disease]], [[Rosai-Dorfman disease]],<ref>{{cite journal |last1=Noguchi |first1=S|last2=Yatera|first2=K|last3=Shimajiri|first3=S|last4=Inoue|first4=N|last5=Nagata|first5=S|last6=Nishida|first6=C|last7=Kawanami|first7=T|last8=Ishimoto|first8=H|last9=Sasaguri|first9=Y|last10=Mukae|first10=H|title=Intrathoracic Rosai-Dorfman disease with spontaneous remission: a clinical report and a review of the literature|journal=The Tokohu Journal of Experimental Medicine|volume=227 |issue=3|pages=231–235 |year=2012|pmid=22789970|url=https://www.jstage.jst.go.jp/article/tjem/227/3/227_231/_pdf |doi=10.1620/tjem.227.231}}</ref> [[Kawasaki disease]],<ref>{{cite journal |last1=Weiss |first1=PF|title=Pediatric vasculitis|journal=Pediatric Clinics of North America|volume=59 |issue=2|pages=407–423|date=April 2012|pmid=22560577|doi=10.1016/j.pcl.2012.03.013 |pmc=3348547}}</ref> [[Kimura disease]]<ref>{{cite journal |last1=Koh |first1=H|last2=Kamiishi|first2=N|last3=Chiyotani|first3=A|last4=Takahashi|first4=H|last5=Sudo|first5=A|last6=Masuda|first6=Y|last7=Shinden|first7=S|last8=Tajima|first8=A|last9=Kimura|first9=Y|last10=Kimura|first10=T|title=Eosinophilic lung disease complicated by Kimura's disease: a case report and literature review|journal=Internal Medicine (Tokyo, Japan)|volume=51 |issue=22|pages=3163–3167|date=April 2012|pmid=23154725|url=https://www.jstage.jst.go.jp/article/internalmedicine/51/22/51_51.8600/_pdf}}</ref>


calcifications have been reported in ~ 83% of Brenner tumours on CT.
==Benign (reactive) lymphadenopathy==
solid component may show mild to moderate enhancement post contrast.
Benign lymphadenopathy is a common biopsy finding, and may often be confused with [[malignant lymphoma]]. It may be separated into major [[morphologic pattern]]s, each with its own [[differential diagnosis]] with certain types of lymphoma. Most cases of [[reactive follicular hyperplasia]] are easy to diagnose, but some cases may be confused with [[follicular lymphoma]]. There are six distinct patterns of benign lymphadenopathy:<ref>{{cite journal | last1 =  | first1 = L. M. | last2 = O'Malley | first2 = D | title= Benign lymphadenopathies | journal = Modern Pathology | volume = 26 Suppl 1 | pages = S88-96 | year = 2013 | pmid = 23281438 | doi = 10.1038/modpathol.2012.176 | author1 = Weiss }}</ref>
* [[Follicular hyperplasia]]: This is the most common type of reactive lymphadenopathy.<ref name="Benign lymphadenopathy">{{cite journal |last1=Weiss |first1=LM|last2=O'Malley|first2=D|title=Benign lymphadenopathies|journal=Modern Pathology|volume=26 |issue=Supplement 1 |pages=S88–S96 |year=2013|pmid=23281438|doi=10.1038/modpathol.2012.176}}</ref>
* [[Paracortical hyperplasia]]/[[Interfollicular hyperplasia]]: It is seen in viral infections, skin diseases, and nonspecific reactions.
* [[Sinus histiocytosis]]: It is seen in lymph nodes draining limbs, inflammatory lesions, and malignancies.
* [[Nodal extensive necrosis]]
* Nodal [[granulomatous inflammation]]
* Nodal extensive [[fibrosis]] (Connective tissue framework)
* [[Nodal deposition of interstitial substance]]


===MRI===
These [[morphological pattern]]s are never pure. Thus, reactive follicular hyperplasia can have a component of paracortical hyperplasia. However, this distinction is important for the [[differential diagnosis]] of the [[etiology|cause]].
MRI may be helpful in the diagnosis of Brenner tumor. Findings on MRI suggestive of Brenner tumor is hypointense on T2 weighted sequences.
 
===Ultrasound===
Ultrasound may be helpful in the diagnosis of Brenner tumor. Findings on ultrasound suggestive of Brenner tumor is a hypochoic solid mass that may be accompanied by calciication.
 
* Findings on ultrasound suggestive of Brenner tumor include:
:* Hypochoic solid masses
:* Calciication (Calcifications have been reported in 50% of Brenner tumours on ultrasound)
 
===Other Imaging Findings===
===Other Diagnostic Studies===
===Biopsy===


==Localization==
*[[Mediastinal lymphadenopathy]]
*[[Bilateral hilar lymphadenopathy]]


==See also==
*[[Adenitis]]
*[[Lymphovascular invasion]]


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Gynecology]]
==External links==
[[Category:Types of cancer]]
*[http://www.humpath.com/spip.php?article13820 HPC:13820] on humpath.com (Digital slides)
[[Category:Oncology]]
 


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Synonyms and keywords: Synonym 1; Synonym 2; Synonym 3

Overview

Lymphadenopathy ( in Greek, adenas ("gland") and patheia ("act of suffering" or "disease") ) refers to lymph nodes which are abnormal in size, number or consistency and is often used as a synonym for swollen or enlarged lymph nodes. Common causes of lymphadenopathy are infection, autoimmune disease, or malignancy.


Classification

  • [Disease name] may be classified according to [classification method] into [number] subtypes/groups:
  • [group1]
  • [group2]
  • [group3]
  • Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].

Pathophysiology

  • The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
  • The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
  • On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
  • On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Causes

  • [Disease name] may be caused by either [cause1], [cause2], or [cause3].
  • [Disease name] is caused by a mutation in the [gene1], [gene2], or [gene3] gene[s].
  • There are no established causes for [disease name].

Differentiating [disease name] from other Diseases

  • [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
  • [Differential dx1]
  • [Differential dx2]
  • [Differential dx3]

Risk Factors

  • Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].


Diagnosis

Diagnostic Criteria

  • The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
  • [criterion 1]
  • [criterion 2]
  • [criterion 3]
  • [criterion 4]

Symptoms

  • [Disease name] is usually asymptomatic.
  • Symptoms of [disease name] may include the following:
  • [symptom 1]
  • [symptom 2]
  • [symptom 3]
  • [symptom 4]
  • [symptom 5]
  • [symptom 6]

Physical Examination

  • Patients with [disease name] usually appear [general appearance].
  • Physical examination may be remarkable for:
  • [finding 1]
  • [finding 2]
  • [finding 3]
  • [finding 4]
  • [finding 5]
  • [finding 6]

Laboratory Findings

  • There are no specific laboratory findings associated with [disease name].
  • A [positive/negative] [test name] is diagnostic of [disease name].
  • An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
  • Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Imaging Findings

  • There are no [imaging study] findings associated with [disease name].
  • [Imaging study 1] is the imaging modality of choice for [disease name].
  • On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
  • [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

  • [Disease name] may also be diagnosed using [diagnostic study name].
  • Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

Surgery

References





Template:Infobox symptom

Lymphadenopathy or lymphadenitis refers to lymph nodes which are abnormal in size, number or consistency [1] and is often used as a synonym for swollen or enlarged lymph nodes. Common causes of lymphadenopathy are infection, autoimmune disease, or malignancy.

Inflammation as a cause of lymph node enlargement is known as lymphadenitis.[2] In practice, the distinction between lymphadenopathy and lymphadenitis is rarely made. Inflammation of the lymphatic vessels is also known as lymphangitis.[3] Infectious lymphadenitides affecting lymph nodes in the neck are often called scrofula.

The term comes from the word lymph and a combination of the Greek words αδένας, adenas ("gland") and παθεία, patheia ("act of suffering" or "disease").

Due to its peculiar high incidence, the presence of lymphadenopathy is a particularly important sign on the diagnosis of HIV or even, untreated later stages of the infection, AIDS.

Types

File:Dermatopathic lymphadenopathy - low mag.jpg
Micrograph of dermatopathic lymphadenopathy, a type of lymphadenopathy. H&E stain.

Causes

Lymph node enlargement is recognized as a common sign of infectious, autoimmune, or malignant disease. Examples may include:

Less common infectious causes of lymphadenopathy may include bacterial infections such as cat scratch disease, tularemia, brucellosis, or prevotella.[citation needed]

Benign (reactive) lymphadenopathy

Benign lymphadenopathy is a common biopsy finding, and may often be confused with malignant lymphoma. It may be separated into major morphologic patterns, each with its own differential diagnosis with certain types of lymphoma. Most cases of reactive follicular hyperplasia are easy to diagnose, but some cases may be confused with follicular lymphoma. There are six distinct patterns of benign lymphadenopathy:[25]

These morphological patterns are never pure. Thus, reactive follicular hyperplasia can have a component of paracortical hyperplasia. However, this distinction is important for the differential diagnosis of the cause.

Localization

See also

References

  1. ↑ King, D; Ramachandra, J; Yeomanson, D (2 January 2014). "Lymphadenopathy in children: refer or reassure?". Archives of Disease in Childhood: Education and Practice Edition. 99: 101–110. doi:10.1136/archdischild-2013-304443. PMID 24385291.
  2. ↑ Template:DorlandsDict
  3. ↑ Template:DorlandsDict
  4. ↑ Fontanilla, JM; Barnes, A; Von Reyn, CF (September 2011). "Current diagnosis and management of peripheral tuberculous lymphadenitis". Clinical Infectious Diseases. 53 (6): 555–562. doi:10.1093/cid/cir454. PMID 21865192.
  5. ↑ Klotz, SA; Ianas, V; Elliott, SP (2011). "Cat-scratch Disease". American Family Physician. 83 (2): 152–155. PMID 21243990.
  6. ↑ Butler, T (2009). "Plague into the 21st century". Clinical Infectious Diseases. 49 (5): 736–742. doi:10.1086/604718. PMID 19606935.
  7. ↑ 7.0 7.1 Weiss, LM; O'Malley, D (2013). "Benign lymphadenopathies". Modern Pathology. 26 (Supplement 1): S88–S96. doi:10.1038/modpathol.2012.176. PMID 23281438.
  8. ↑ Sweeney, DA; Hicks, CW; Cui, X; Li, Y; Eichacker, PQ (December 2011). "Anthrax infection". American Journal of Respiratory and Critical Care Medicine. 184 (12): 1333–1341. doi:10.1164/rccm.201102-0209CI. PMC 3361358. PMID 21852539.
  9. ↑ Kennedy, PG (February 2013). "Clinical features, diagnosis, and treatment of human African trypanosomiasis (sleeping sickness)". Lancet Neurology. 12 (2): 186–194. doi:10.1016/S1474-4422(12)70296-X. PMID 23260189.
  10. ↑ 10.0 10.1 10.2 Status and anamnesis, Anders Albinsson. Page 12
  11. ↑ Kim, TU; Kim, S; Lee, JW; Lee, NK; Jeon, UB; Ha, HG; Shin, DH (September–October 2012). "Plasma cell type of Castleman's disease involving renal parenchyma and sinus with cardiac tamponade: case report and literature review". Korean Journal of Radiology. 13 (5): 658–663. doi:10.3348/kjr.2012.13.5.658. PMC 3435867. PMID 22977337.
  12. ↑ Zhang, H; Wang, R; Wang, H; Xu, Y; Chen, J (June 2012). "Membranoproliferative glomerulonephritis in Castleman's disease: a systematic review of the literature and 2 case reports". Internal Medicine (Tokyo, Japan). 51 (12): 1537–1542. doi:10.2169/internalmedicine.51.6298. PMID 22728487.
  13. ↑ Bratucu, E; Lazar, A; Marincaş, M; Daha, C; Zurac, S (March–April 2013). "Aseptic mesenteric lymph node abscesses. In search of an answer. A new entity?" (PDF). Chirurgia (Bucarest, Romania: 1990). 108 (2): 152–160. PMID 23618562.
  14. ↑ Leung, A; Sigalet, DL (June 2003). "Acute Abdominal Pain in Children". American Family Physician. 67 (11): 2321–2327.
  15. ↑ Glass, C (September 2008). "Role of the Primary Care Physician in Hodgkin Lymphoma". American Family Physician. 78 (5): 615–622. PMID 18788239.
  16. ↑ Colon, NC; Chung, DH (2011). "Neuroblastoma". Advances in Pediatrics. 58 (1): 297–311. doi:10.1016/j.yapd.2011.03.011. PMC 3668791. PMID 21736987.
  17. ↑ Sagatys, EM; Zhang, L (January 2011). "Clinical and laboratory prognostic indicators in chronic lymphocytic leukemia". Cancer Control. 19 (1): 18–25. PMID 22143059.
  18. ↑ Melikoglu, MA; Melikoglu, M (October–December 2008). "The clinical importance of lymphadenopathy in systemic lupus erythematosus" (PDF). Acta Reumatologia Portuguesa. 33 (4): 402–406. PMID 19107085.
  19. ↑ Lederman, MM; Margolis, L (June 2008). "The lymph node in HIV pathogenesis". Seminars in Immunology. 20 (3): 187–195. doi:10.1016/j.smim.2008.06.001. PMC 2577760. PMID 18620868.
  20. ↑ Quan, D (October 2012). "North American poisonous bites and stings". Critical Care Clinics. 28 (4): 633–659. doi:10.1016/j.ccc.2012.07.010. PMID 22998994.
  21. ↑ Komagamine, T; Nagashima, T; Kojima, M; Kokubun, N; Nakamura, T; Hashimoto, K; Kimoto, K; Hirata, K (September 2012). "Recurrent aseptic meningitis in association with Kikuchi-Fujimoto disease: case report and literature review". BMC Neurology. 12: 187–195. doi:10.1186/1471-2377-12-112. PMC 3570427. PMID 23020225.
  22. ↑ Noguchi, S; Yatera, K; Shimajiri, S; Inoue, N; Nagata, S; Nishida, C; Kawanami, T; Ishimoto, H; Sasaguri, Y; Mukae, H (2012). "Intrathoracic Rosai-Dorfman disease with spontaneous remission: a clinical report and a review of the literature". The Tokohu Journal of Experimental Medicine. 227 (3): 231–235. doi:10.1620/tjem.227.231. PMID 22789970.
  23. ↑ Weiss, PF (April 2012). "Pediatric vasculitis". Pediatric Clinics of North America. 59 (2): 407–423. doi:10.1016/j.pcl.2012.03.013. PMC 3348547. PMID 22560577.
  24. ↑ Koh, H; Kamiishi, N; Chiyotani, A; Takahashi, H; Sudo, A; Masuda, Y; Shinden, S; Tajima, A; Kimura, Y; Kimura, T (April 2012). "Eosinophilic lung disease complicated by Kimura's disease: a case report and literature review". Internal Medicine (Tokyo, Japan). 51 (22): 3163–3167. PMID 23154725.
  25. ↑ Weiss, L. M.; O'Malley, D (2013). "Benign lymphadenopathies". Modern Pathology. 26 Suppl 1: S88–96. doi:10.1038/modpathol.2012.176. PMID 23281438.

External links

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