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Unusual Initial Presentation of Herpes Simplex Virus as Inguinal Lymphadenopathy
Genital herpes simplex virus (HSV) infections are a common cause of inguinal lymphadenopathy. However, surgical excision of enlarged inguinal nodes is almost never performed to initially diagnose genital herpes simplex virus, due to the distinct external presentation of genital herpetic vesicles tha...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357043/ https://www.ncbi.nlm.nih.gov/pubmed/25815228 http://dx.doi.org/10.1155/2015/573230 |
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author | Fleming, Sarah A. Strickler, John G. |
author_facet | Fleming, Sarah A. Strickler, John G. |
author_sort | Fleming, Sarah A. |
collection | PubMed |
description | Genital herpes simplex virus (HSV) infections are a common cause of inguinal lymphadenopathy. However, surgical excision of enlarged inguinal nodes is almost never performed to initially diagnose genital herpes simplex virus, due to the distinct external presentation of genital herpetic vesicles that usually occur with the first symptoms of infection. Therefore, the histologic and immunophenotypic features of HSV-associated inguinal lymphadenopathy are unfamiliar to most pathologists. The current report describes the lymph node pathology of two immunocompetent patients, whose initial HSV diagnosis was established through surgical excision of enlarged inguinal lymph nodes. Histologic examination showed features consistent with viral lymphadenopathy, including florid follicular hyperplasia, monocytoid B-cell hyperplasia, and paracortical hyperplasia without extensive necrosis. Immunohistochemical stains for HSV antigens, using polyclonal anti-HSV I and II antibodies, demonstrate strong immunoreactivity for HSV in a small number of cells in the subcapsular sinuses, especially in areas with monocytoid B-cell hyperplasia. Rare scattered HSV-positive cells also are identified in paracortical areas and germinal centers. We conclude that an initial diagnosis of genital HSV infection may be established by inguinal lymph node biopsy. |
format | Online Article Text |
id | pubmed-4357043 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-43570432015-03-26 Unusual Initial Presentation of Herpes Simplex Virus as Inguinal Lymphadenopathy Fleming, Sarah A. Strickler, John G. Case Rep Pathol Case Report Genital herpes simplex virus (HSV) infections are a common cause of inguinal lymphadenopathy. However, surgical excision of enlarged inguinal nodes is almost never performed to initially diagnose genital herpes simplex virus, due to the distinct external presentation of genital herpetic vesicles that usually occur with the first symptoms of infection. Therefore, the histologic and immunophenotypic features of HSV-associated inguinal lymphadenopathy are unfamiliar to most pathologists. The current report describes the lymph node pathology of two immunocompetent patients, whose initial HSV diagnosis was established through surgical excision of enlarged inguinal lymph nodes. Histologic examination showed features consistent with viral lymphadenopathy, including florid follicular hyperplasia, monocytoid B-cell hyperplasia, and paracortical hyperplasia without extensive necrosis. Immunohistochemical stains for HSV antigens, using polyclonal anti-HSV I and II antibodies, demonstrate strong immunoreactivity for HSV in a small number of cells in the subcapsular sinuses, especially in areas with monocytoid B-cell hyperplasia. Rare scattered HSV-positive cells also are identified in paracortical areas and germinal centers. We conclude that an initial diagnosis of genital HSV infection may be established by inguinal lymph node biopsy. Hindawi Publishing Corporation 2015 2015-02-26 /pmc/articles/PMC4357043/ /pubmed/25815228 http://dx.doi.org/10.1155/2015/573230 Text en Copyright © 2015 S. A. Fleming and J. G. Strickler. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Fleming, Sarah A. Strickler, John G. Unusual Initial Presentation of Herpes Simplex Virus as Inguinal Lymphadenopathy |
title | Unusual Initial Presentation of Herpes Simplex Virus as Inguinal Lymphadenopathy |
title_full | Unusual Initial Presentation of Herpes Simplex Virus as Inguinal Lymphadenopathy |
title_fullStr | Unusual Initial Presentation of Herpes Simplex Virus as Inguinal Lymphadenopathy |
title_full_unstemmed | Unusual Initial Presentation of Herpes Simplex Virus as Inguinal Lymphadenopathy |
title_short | Unusual Initial Presentation of Herpes Simplex Virus as Inguinal Lymphadenopathy |
title_sort | unusual initial presentation of herpes simplex virus as inguinal lymphadenopathy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357043/ https://www.ncbi.nlm.nih.gov/pubmed/25815228 http://dx.doi.org/10.1155/2015/573230 |
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