Clinical History:
- A 30-year-old African-American man complained of fever, night sweats, fatigue, weight loss, and shortness of breath for several months. A chest x-ray
revealed prominent bilateral hilar lymphadenopathy. Physical examination
revealed cervical lymphadenopathy. A cervical node biopsy was performed
(images 9.1 through 9.3 demonstrate the histopathologic findings).
Microbiologic culture of the node showed no growth of bacteria, fungi, or
mycobacteria.
- What general type of inflammatory process is seen in the section of lymph node?
Granuloma. However, there is no central necrosis (caseation).
- What inflammatory cell types are present?
Epithelioid cells, multinucleated giant cells, and a few lymphocytes are seen.
- What is the diagnosis?
The major differential diagnosis is tuberculosis vs sarcoidosis. Given that the culture is negative, a diagnosis of sarcoidosis may be made.
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