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Mediastinal tumours
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
It can be difficult to distinguish benign hyperplasia from tumour infiltration on the basis of imaging alone (66). Thymic enlargement can appear on CT and MRI as an anterior mediastinal mass, which may be confused with a neoplastic process (73). Awareness of the possibility of benign thymic enlargement in these patients may prevent invasive diagnostic procedures. On the initial studies, no anterior mediastinal mass is usually seen in the adult patient. The development of a new anterior mediastinal mass in the normal site of the thymus is the first finding. Diffuse symmetric enlargement of the gland, a smooth contour and normal vessels are the key morphological features of hyperplasia, whereas neoplasm tends to manifest as a focal mass with nodular contour and necrotic or calcified foci. Detecting fat in the thymus is particularly relevant in these situations. In- and out-of-phase MRI maybe useful in this situation. In the setting of Hodgkin lymphoma, thymic involvement by the lymphoma is usually accompanied by lymph node disease in the mediastinum. In patients with solid tumours, infiltration of the thymus by these tumours is rare, and thus benign thymic hyperplasia after chemotherapy is the most likely diagnosis. Lack of clinical or imaging evidence of recurrence at any other site may serve as further support of thymic rebound. Typically, it is an arrowhead-shaped triangular structure, with a bilobed configuration and with convex borders and of homogeneous soft tissue density. Lymphoid hyperplasia may appear normal (45%), enlarged (35%), or as a focal thymic mass (20%) (48).
The gastrointestinal system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Sharon J. White, Francis A. Carey
These include strangulation of bowel in a hernia sac (see Figure 10.41) and volvulus. The latter is an apparently spontaneous twist in a loop of bowel (often small intestine or sigmoid colon). This may occur around a congenital or acquired fibrous adhesion or as a result of an unusually long mesentery. Volvulus and strangulation lead to luminal obstruction and eventually to infarction by venous thrombosis. Intussusception is an invagination of one bowel segment into another. There is usually a lesion at the apex of the invaginating bowel. This may be a polyp or an intramural tumour, or something as simple as a focus of lymphoid hyperplasia. The hyperplasia is usually the case in ileocolic intussusception, the most common type seen in clinical practice.
Sleep Apnea in Children History and Physical Exam
Published in Mark A. Richardson, Norman R. Friedman, Clinician’s Guide to Pediatric Sleep Disorders, 2016
In general, symptoms of obstruction that occur during the day will likely produce symptoms at night as well. A history of difficulty with swallowing due to enlarged tonsils, pharyngeal speech, or nasal obstruction should lead to questions about sleep and the possibility of apnea. There may often be brief episodes of nighttime breathing difficulty associated with acute upper respiratory infections that cause lymphoid enlargement. These episodes are usually self-limiting and resolve spontaneously. Supportive care during the episode is usually all that is needed. In some cases, however, once lymphoid hyperplasia occurs, prolonged symptomatic obstruction can take place. Establishing the chronicity and consistency of symptoms is critical in decision-making.
Gut inflammation in CVID: causes and consequences
Published in Expert Review of Clinical Immunology, 2022
Nodular lymphoid hyperplasia is a common finding in the gut of CVID patients (Figure 3) detected in 38–53% of CVID patients in two cross-sectional studies, including both symptomatic and un-symptomatic patients [19,30]. Nodular lymphoid hyperplasia was associated with increased numbers of circulating B-cells, but not GI symptoms [19]. Both the cause and consequences of lymphoid hyperplasia are unknown. An association between lymphoid hyperplasia and G. lamblia has been suggested [22], but lymphoid hyperplasia was frequently found (38%) in a cohort where G. lamblia was tested, but not detected [19]. We suggest that lymphoid hyperplasia in the gut is not separate from lymphoid hyperplasia in lymph nodes or in other organs, e.g. the spleen, and is a clinical manifestation of immune dysregulation and not related to GI infections.
Effect of sleep deprivation and daylight restriction on the immune response to Escherichia coli-induced septicemia in Wistar rats
Published in Egyptian Journal of Basic and Applied Sciences, 2023
Abayomi O. Ige, Esther O. Agbo, Dorcas J. Brown, Olakunle O. Mebude, Elsie O. Adewoye
However, interferon-γ (INF-γ) and tumor necrosis factor-alpha (TNF-α), which are both proinflammatory cytokines [34], were not elevated in the ECIS group. This suggests that the induced septicemia in this group may not have activated chronic proinflammation cytokines at the time of sample collection (7 days post exposure). The consequent lymphoid hyperplasia noted in this group is however associated with the presence of systemic infection [35]. In addition, the elevated levels of immunoglobulin G, an antibody that protects against and controls infection, and immunoglobulin M that serve as the first line of host defense against infection and play important roles in immune regulation and tolerance [36], in the ECIS group suggested activation of immune response.
A single-institution review of lacrimal gland biopsies between 1962 and 2017
Published in Orbit, 2023
Catherine J. Choi, Ann Q. Tran, Apostolos G. Anagnostopoulos, Henry W. Zhou, David T. Tse, Sander R. Dubovy
The lymphoproliferative category made up 21% of all cases with MALT lymphoma being the predominant type. Cases reported as non-diagnostic for lymphoma often had a high clinical suspicion, and sometimes with evidence of small foci of atypia but ultimately negative for malignant lymphoma. These might be categorized as atypical lymphoid hyperplasia in other studies. In addition to representing the biopsy sampling error as above, this subset also likely demonstrates the spectrum of lymphoproliferative disorders, where benign lymphoid hyperplasia and atypical lymphoid hyperplasia can eventually evolve into lymphoma.