Non-Neoplastic Hematopathology And Infections

Most books on hematopathology are neoplastic in scope and offer little non-neoplastic content. In Non-Neoplastic Hematopathology and Infections, the authors fully describe the hematologic manifestations in tissue and blood of infectious agents, including many rare and exotic diseases found in both Western and Eastern hemispheres, in order to assist pathologists and medical laboratory professionals all over the world in better diagnosing and treating such infections.


Thoroughly illustrated with photographs, tables and text, this book features a wide range of non-neoplastic hematologic disorders, as well as reactive patterns of non-infectious and infectious agents. Comprehensive and state-of-the-art diagnostic materials are described, as are the epidemiology, pathobiology, clinical and pathologic manifestations in blood and lymphatic organs—as well as the approaches to treatment.


In addition, Non-Neoplastic Hematopathology and Infections:


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Contains detailed information on the pathology and patterns of blood, lymph node, and a number of bone marrow and splenic infections and infectious agent manifestations


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Thoroughly updates the classic pathology of reactive lymphadenopathies and extends this pattern-based approach to tropical and emergent infections


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Promotes the multidisciplinary integration of hematopathologists and microbiologists in the analysis and diagnostic work-up of tissue and blood


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Complements current major treatises on such tropical diseases as Manson's, Ashworth's, and Doerr's and updates the classic tomes of William St. Clair Symmers and current texts on neoplastic hematopathology




Non-Neoplastic Hematopathology and Infections is an important book for any medical professional interested in non-neoplastic hematology, infections and tissue hematopathology, infectious diseases and tropical medicine, and tropical hematopathology.

Hernani Cualing MD, is Associate Professor in the Department of Pathology and Cell Biology and Director of the Hematopathology Fellowship Training Program at the University of South Florida College of Medicine in Tampa, Florida. He is also an active hematopathologist at the Moffitt Cancer Center and Research Institute there. In addition to his research into such topics as mantle cell and T cell lymphomas, Dr. Cualing has long been fascinated with the analysis, diagnosis, and treatment of non-neoplastic and infectious blood, marrow, and lymph diseases.


Parul Bhargava, MD, is Medical Director in the Hematology Laboratory at Beth Israel Deaconess Medical Center-Needham Campus in Boston, and a staff and faculty physician in the Pathology department there. Her primary research interests are in studying hematopoietic neoplasms and newer markers in Hodgkin Lymphoma, but she also has a strong, separate clinical interest in studying the effects of immunodeficiency and infections, particularly HIV, on the hematopoietic system.


Ramon L. Sandin, MD, MS, FCAP, ABP-MM, is a Clinical Pathologist and Medical Director of Clinical Microbiology and Virology in the Department of Hematopathology, Laboratory Medicine, and in the Blood and Marrow Transplant Program at the Moffitt Cancer Center in Tampa, Florida 33612-9497. His special areas of expertise and research interests are in clinical microbiology and virology, and laboratory diagnosis of infectious diseases. This includes 'wet' laboratory work-ups and tissue section diagnosis as well as molecular diagnostic techniques.

Contributors, xix


Foreword, xxiii


Preface, xxv


Acknowledgments, xxvii


Introduction, xxix


PART I Non-neoplastic Hematology 1


CHAPTER ONE Non-neoplastic Disorders of White Blood Cells 3
Rebecca A. Levy, Vandita P. Johari, and Liron Pantanowitz


Overview of WBC Production and Function, 3


Quantitative Disorders of WBCS, 6


Qualitative Disorders of WBCS, 21


References, 26


CHAPTER TWO Non-neoplastic Disorders of Platelets 31
Lija Joseph


Platelet Production Structure and Function, 31


Quantitative Disorders of Platelets, 33


Qualitative Disorders of Platelets, 39


References, 43


CHAPTER THREE Approach to Disorders of Red Blood Cells 45
Jason C. Ford


Introduction, 45


The Anemias, 45


The Approach to Anemia, 50


The Polycythemias, 63


References, 63


CHAPTER FOUR Microcytic, Normocytic, and Macrocytic Anemias 65
Reza Setoodeh and Loveleen C. Kang


Microcytic Anemias, 65


Normocytic Anemias, 74


Macrocytic Anemias, 81


References, 86


CHAPTER FIVE Disorders of Hemoglobin 89
Parul Bhargava


Overview, 89


Quantitative Disorders of Hemoglobin, 89


Qualitative Disorders of Hemoglobin, 97


Mixed–Quantitative Qualitative Disorders of Hemoglobin, 104


Double Heterozygous States, 105


Approach to Diagnosis of Hemoglobin Disorders, 106


References, 111


PART II Infectious Aspects of Hematology 113


CHAPTER SIX Apicomplexal Parasites of Peripheral Blood, Bone Marrow, and Spleen: The Genera Plasmodium, Babesia, and Toxoplasma 115
Lynne S. Garcia


Plasmodium, 115


Babesia, 125


Toxoplasma, 128


References, 134


CHAPTER SEVEN Blood and Tissue Flagellates of the Class Kinetoplastidea: The Genera Leishmania and Trypanosoma 139
Raul E. Villanueva and Stephen D. Allen


Leishmaniasis, 139


Chagas' Disease, 145


African Trypanosomiasis, 150


References, 155


CHAPTER EIGHT Proteobacteria and Rickettsial Agents: Human Granulocytic Anaplasmosis and Human Monocytic Ehrlichiosis 159
Sheldon Campbell and Tal Oren


Microbiology and Epidemiology of HGA and HME, 159


Clinical Syndromes, 160


Differential Diagnosis, 160


Diagnostic Approach, 161


Prevention and Treatment, 163


References, 163


CHAPTER NINE Clinically Significant Fungal Yeasts 165
Ramon L. Sandin


Introduction, 165


Histoplasma capsulatum var. capsulatum (H. capsulatum), 166


Blastomyces dermatitidis, 170


Coccidioides immitis, 174


Cryptococcus neoformans, 178


Candida albicans and other Candida Species, 183


Malassezia furfur, 188


References, 193


CHAPTER TEN Hematologic Aspects of Tropical Infections 195
Deniz Peker


Anemia in Tropical Infections, 195


Vascular Purpuras, 202


References, 203


PART III Non-neoplastic Lymph Node Pathology and Infections 205


CHAPTER ELEVEN Classification of Reactive Lymphadenopathy 207
Hernani D. Cualing


Introduction, 207


References, 229


CHAPTER TWELVE Lymph Node Biology, Markers and Disease 231
Hernani D. Cualing


Peripheral Lymphoid Tissue, 231


Pathophysiology, 231


Cortex, 232


Paracortex, 240


Sinus Histiocytes, 242


Epithelioid Histiocytes


and Granulomas, 243


Nodal Framework, 243


References, 246


CHAPTER THIRTEEN Lymphadenopathy with Predominant Follicular Patterns 249
Shohreh Iravani Dickinson, Jun Mo, and Hernani D. Cualing


Germinal Center Hyperplasia, 249


Regressive Transformation of Germinal Center (Atrophic) Pattern, 256


Progressive Transformation of Germinal Center Pattern, 267


Marginal Zone Hyperplasia and Mantle Cell Hyperplasia, 273


Reactive Follicular Pattern, Mixed with Other Patterns, Specific Entities, 276


Mixed Pattern with Follicular Hyperplasia, Microgranulomas, Monocytoid Hyperplasia, 278


Follicular Hyperplasia with Capsular Fibrosis and Plasmacytosis-Syphilis, 282


References, 284


CHAPTER FOURTEEN Reactive Lymphadenopathy with Paracortical Pattern, Noninfectious Etiology 291
Ling Zhang and Jeremy W. Bowers


Paracortical Hyperplasia, 291


Dermatopathic Lymphadenopathy, 297


Reactive Immunoblastic Proliferation, 301


Postvaccinal Lymphadenitis, 307


Drug-Induced Lymphadenopathy, 309


Anticonvulsant (Phenytoin)-Related Lymphoproliferative Disorder, 309


Methotrexate-Related Lymphoproliferative Disorder, 312


References, 315


CHAPTER FIFTEEN Reactive Lymphadenopathy with Diffuse Paracortical Pattern—Infectious Etiology 323
Jeremy W. Bowers and Ling Zhang


Introduction, 323


Infectious Mononucleosis Lymphadenitis, 323


Cytomegalovirus Lymphadenitis, 329


Herpes Simplex Virus Lymphadenitis, 333


Varicella Zoster Lymphadenitis, 337


References, 340


CHAPTER SIXTEEN Reactive Lymphadenopathy with Sinus Pattern 347
Hernani D. Cualing


Sinuses and Vascular Supply, 347


Sinus Histiocytosis, Nonspecific, 347


Signet Ring Histiocytosis, 354


Sinus Histiocytosis with Massive Lymphadenopathy (or Rosai–Dorfman Disease), 355


Pigmented Sinus Histiocytic Pattern Secondary to Iron Overload from Hemochromatosis, Transfusion, or Hemolysis, 357


Histiocytic Reaction to Foreign Matter, 359


Sinus Pattern from Extramedullary Hematopoiesis, 361


Immature "Sinus Histiocytosis" or Monocytoid B-Cell Hyperplasia, 363


Reactive Hemophagocytic Syndromes, 365


Vascular Transformation of Sinuses (VTS), 366


Whipple's Disease (WD) Lymphadenopathy, 368


References, 370


CHAPTER SEVENTEEN Mixed Lymph Node Patterns: Stromal and Histiocytic Reactions, NonInfectious 375
Hernani D. Cualing


Proteinaceous Lymphadenopathy Including Immunoglobulin Deposition Lymphadenopathy, 375


Lymph Node Fibrosis or Fibrotic Changes, Nonspecific, 377


Inflammatory Pseudotumor of Lymph Nodes, 379


Fatty Replacement or Fatty Changes, Nonspecific, 383


Tumor Reactive Granulomatas, 384


References, 386


CHAPTER EIGHTEEN Mixed Lymph Node Patterns: Including Granulomatous Lymphadenopathy, Noninfectious 389
Xiaohui Zhang and Hernani D. Cualing


Mixed Pattern with Follicular Hyperplasia and Eosinophilia, 389


Mixed Nonnecrotizing ‘‘Dry’’ Granulomas, 396


Mixed Pattern with Hemorrhage and Infarction, 404


Mixed Necrotizing Pattern with No or Minimal Granulomas, 406


Necrotizing Nonsuppurative Granulomatas, 410


Necrotizing Suppurative Granulomatas, 413


Granulomatous Change within Germinal Centers, 415


Mixed Pattern with Plasmacytosis, 418


References, 420


CHAPTER NINETEEN Mixed Patterns in Lymph Node, Suppurative Necrotizing Granulomatous Infectious Lymphadenopathy 427
Hernani D. Cualing and Gary Hellerman


Cat-Scratch Disease, 427


Tularemia, 431


Lymphogranuloma venereum, 433


Chancroid, H. ducreyi, 434


Yersinia enterocolitica/pseudotuberculosis Lymphadenitis, 435


Brucellosis, 437


Melioidosis, 439


Typhoid Lymphadenitis (Salmonella typhi), 442


References, 444


CHAPTER TWENTY Mixed Patterns: Emergent/Tropical Infections with Characterized Lymphadenopathy 447
Hernani D. Cualing


Mixed Pattern with Granulomatas and Diagnostic Microorganisms, 447


Lymphadenopathy Secondary to Localized Filariasis, 449


Schistosomiasis, 453


Leishmaniasis, 454


Mixed Pattern with Granulomas and Foamy Macrophages, 457


Mixed Pattern with Deposition of Interstitial Substance, 459


Mixed Pattern with Caseation Necrosis, 461


Mixed Pattern Atypical Mycobacterial Infections in AIDS, 463


Mixed Pattern with Angiomatoid Change, 467


Mixed Pattern with Spent Granulomas and Extracellular Organisms, 470


African Histoplamosis Secondary to H. capsulatum var duboisii, 474


References, 476


CHAPTER TWENTY-ONE Cytopathology of Non-neoplastic and Infectious Lymphadenopathy 481
Sara E. Monaco, Liron Pantanowitz, and Walid E. Khalbuss


Technical Components, 483


Approach to Cytomorphologic Evaluation of Lymph Nodes, 484


FNA Reporting Terminology, 485


Intraoperative Touch Preparation, 487


Reactive Lymphoid Hyperplasia, 487


Inflammatory and Infectious Causes of Lymphadenopathy, 488


Other Causes of Lymphadenopathy, 497


Lymphadenopathy in the Pediatric Patient, 504


Use of Ancillary Studies, 504


Molecular Studies, 506


References, 506


CHAPTER TWENTY-TWO Mixed Patterns In Lymph Node: Tropical Infectious Lymphadenopathy and Hematopathology, Not Otherwise Characterized 511
Hernani D. Cualing


Introduction, 511


Hemorrhagic Lymphadenopathy, 511


Sinus Pattern, 517


Diffuse Pattern with Depletion and Atypical Immunoblastic Reaction, 525


Unusual Granulomas Q Fever, 531


References, 533


PART IV Non-neoplastic Findings in Bone Marrow Transplantation 537


CHAPTER TWENTY-THREE Non-neoplastic Hematopathology of Bone Marrow Transplant and Infections 539
Taiga Nishihori and Ernesto Ayala


Introduction, 539


Fundamental Principles of Hematopoietic Cell Transplantation (HCT), 539


Characteristics of Pretransplant Bone Marrow, 542


Hematopoietic Regeneration, 542


Chimerism, 543


Post-Transplantation Marrow, 543


Complications of Hematopoietic Regeneration, 547


Conclusion, 551


References, 552


Index, 559