Follicular hyperplasia

Follicular lymphatic hyperplasia, HE

Follicular hyperplasia is a condition characterized by the enlargement of lymph nodes due to an increase in the number of follicles, which are small compartments within the lymph nodes that contain immune system cells. This condition is often a response to various stimuli, including infections, autoimmune diseases, and sometimes, more rarely, certain types of cancer. Follicular hyperplasia is considered a type of lymphadenopathy, which refers to diseases of the lymph nodes.

Causes

Follicular hyperplasia can be caused by a variety of factors, each leading to an increased immune response. Common causes include:

• Viral infections, such as Epstein-Barr virus (EBV), which is associated with infectious mononucleosis
• Bacterial infections, including streptococcal infections and Lyme disease, caused by Borrelia burgdorferi
• Autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus (SLE)
• HIV/AIDS, where the virus directly affects the immune system, leading to various lymph node changes

Symptoms

The primary symptom of follicular hyperplasia is the enlargement of lymph nodes, which can occur in various parts of the body, including the neck, armpits, and groin. These enlarged lymph nodes are usually painless and can be felt as firm, rubbery nodules under the skin. In some cases, individuals may also experience systemic symptoms such as fever, night sweats, and weight loss, especially if the underlying cause is an infection or a systemic disease.

Diagnosis

Diagnosis of follicular hyperplasia involves a combination of clinical evaluation and laboratory tests. A detailed medical history and physical examination are crucial. Diagnostic tests may include:

• Blood tests to identify infections or autoimmune diseases
• Imaging studies, such as ultrasound or computed tomography (CT) scans, to assess the size and distribution of lymph nodes
• Biopsy of the affected lymph node, which is the definitive test for diagnosing follicular hyperplasia. Histological examination will show an increase in lymphoid follicles with preserved architecture.

Treatment

Treatment of follicular hyperplasia focuses on addressing the underlying cause. If an infection is identified, appropriate antibiotics or antiviral medications may be prescribed. In cases of autoimmune diseases, immunosuppressive drugs may be required. In most instances, treating the underlying condition leads to a reduction in lymph node size and resolution of symptoms. In rare cases where follicular hyperplasia is associated with malignancy, more specific cancer treatments may be necessary.

Prognosis

The prognosis for individuals with follicular hyperplasia largely depends on the underlying cause. In many cases, with appropriate treatment, the condition resolves without leading to serious complications. However, ongoing monitoring may be necessary to ensure that the lymphadenopathy does not progress or indicate a more serious underlying condition.