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Review
. 2021 Apr;113(2):126-130.
doi: 10.32074/1591-951X-139.

Toxoplasma cyst detection in Piringer-Kuchinka lymphadenitis. Report of two cases and literature review

Luca Ventura #  1   2 , Magda Zanelli #  3 , Maurizio Zizzo  4   5 , Francesca Sanguedolce  6 , Giovanni Martino  7 , Carolina Castro Ruiz  4   5 , Valerio Annessi  4 , Stefano Ascani  8
Affiliations
Review

Toxoplasma cyst detection in Piringer-Kuchinka lymphadenitis. Report of two cases and literature review

Luca Ventura et al. Pathologica. 2021 Apr.

Abstract

The diagnosis of acute toxoplasmic lymphadenitis is traditionally based on the combination of lymph node excisional biopsy with specific tests. The classic triad (marked follicular hyperplasia, small irregular clusters of epithelioid histiocytes in germinal centers, and sinusoidal distension by monocytoid B lymphocytes) is considered diagnostic of the so-called Piringer-Kuchinka lymphadenitis. Toxoplasma gondii organisms have been exceptionally disclosed in such histopathological setting, establishing the diagnosis of toxoplasmic lymphadenitis. Two cases of Piringer-Kuchinka lymphadenitis with toxoplasma cyst demonstration are reported, along with a complete review of the literature.

Keywords: Toxoplasma gondii; bradyzoites; follicular hyperplasia; toxoplasma cyst; toxoplasmic lymphadenitis.

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Conflict of interest statement

Conflict of interest

The Authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Medium power view of lymph node showing a reactive germinal center (left), sheets of monocytoid cells (middle) and small clusters of histiocytes (right) (HE 200x).
Figure 2.
Figure 2.
High power view disclosing a bradyzoites-filled cyst (HE 400x).
Figure 3.
Figure 3.
Anti-toxoplasma antibody positivity (immunostain).
Figure 4.
Figure 4.
Lymph node showing reactive germinal centers with small clusters of histiocytes and sinusoidal distension by monocytoid cells (HE 100x).
Figure 5.
Figure 5.
Toxoplasma cyst located at the margin of a hyperplastic germinal center, stained with (A) PAS, and (B) Grocott (400x).
Figure 6.
Figure 6.
Immunostains for (A) CD20, (B) CD10, and (C) bcl-2 (200x).
See this image and copyright information in PMC

References

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