autoimmune lymphoproliferative disease pathology

autoimmune disease

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Clinical

middle aged women
hx of autoimmune disease

Histology

follicular hyperplasia
paracortex and medulla plasma cells
sinus histiocytosis, neutrophilia

Stains

germinal centers CD10+, Bcl6+, Bcl2-
polytypic plasma cells

Ddx

nonspecific follicular hyperplasia
- no hx of autoimmune disease
syphilis
- warthin-starry stains spirochetes
early viral infection
- HIV
  - follicle lysis
- CMV
- toxoplasma
  - epithelioid histiocytes in follicles
- IgG4 lymphadenopathy
  - plasmacytosis and scattered eosinophils
IgG4 lymphadenopathy
- plasmacytosis positive for IgG4
- eosinophils
follicular lymphoma
- monotonous follicles
- follicles Bcl2+