Morphological Study of Reactive Follicular Hyperplasia Lymph Node

Aim: To establish standard for diagnosis of reactive follicular hyperplasia of lymph node. Methods: This study was conducted at the Department of Pathology, Benazir Bhutto Shaheed College Mirpur, Govt of AJK. 50 cases of reactive follicular hyperplasia were included in the study. Five micron thick, paraffin embedded sections were stained with H & E and reticulin stain. Results: The median number of follicles per low power field (4x objective x 10 eye piece) was 19. The mantle zone was present in 94% of cases. Fifty percent cases showed polarity of the follicles. Monomorphism was absent in all cases. The median number of mitotic figures per 5 follicles was 17 under high power magnification. The median number of tingible body macrophages was 35/5 follicles. Conclusion: The study distinguished the morphological features of reactive follicular hyperplasia which can be helpful to distinguish from follicular lymphoma. By studying the various histopathological features and employing morphological standards for the differentiation of reactive follicular hyperplasia from follicular lymphoma, an accurate diagnosis can be made in most of the cases. The preserved architecture; presence of tingible body macrophages, the mantle zone of mature lymphocytes and absence of monomorphism favour the diagnosis of follicular hyperplasia.