Qap (Anatomical Pathology) 

QAP Peer Review

AP313
Case History: F/12 Cervical lymphadenopathy. Exicional biopsy
Intended diagnosis: Toxoplasma lymphadenitis. Contributed by:MST
Code Diagnosis Comment Score
anonymous Granulomatous inflammation (100%), suggestive of Toxoplasmosis To confirm by serology  100
anonymous Toxoplasmosis of lymph node nil  100
anonymous Reactive lymphadenitis, consistent with toxoplasmosis nil  100
anonymous Reactive lymphoid hyperplasia with microgranulomas and monocytoid B cell hyperplasia; suggestive of toxoplasmosis Serologic studies for toxoplasmosis; special stains to rule out other infective agents e.g. Zeihl Neelsen stain for acid fast bacilli; Grocott stain for fungus.  100
anonymous Toxoplasmic lymphadenitis Check serology. Correlate with history of contact with cats. *To exclude tuberculosis by ZN stain, +/-PCR, and culture.  100
anonymous Reactive lymphadenopathy, in keeping with Toxoplasmosis lymphadenitis (100%) Serology test for Toxoplasma is required to confirm the diagnosis  100
anonymous Cervical lymph node - Toxoplasma lymphadenitis 100% To correlate with serology and/or do immunostaining for organism localization  100
anonymous Granulomatous lymphadenitis, suggestive of Toxoplasmosis Suggest correlate with serology result  100
anonymous Granulomatous lymphadenopathy consistent with Toxoplasmosis. 100% The possibility of mycobacterial infection needs to be excluded. Suggest Ziehl Neelsen stain and correlation with culture result.  100
anonymous Infectious lymphadenitis, favoring Toxoplasmic lymphadenitis Immunostain for Toxoplasma for confirmation. Correlation with clinical history and serologic study advised.  100
anonymous LYMPH NODE, cervical, excisional biopsy - GRANULOMATOUS LYMPHADENITIS with monocytoid B cell proliferation, most compatible with toxoplasmosis infection, for PCR of toxoplasma DNA to confirm diagnosis. nil  100
anonymous Granulomatous inflammation. (100%) (Please see comment for the finding the cause of the granulomatous inflammation) 1. Correlate with clinical finding and family history to see if the possibility of chronic granulomatous disease. 2. Perform PCR test for toxoplasmosis. 3. Perform micro-organism stains including Zeihl-Neelsen stain, Gram stain, Grocott stain and Warthin-Starry stain to look for micro-organism.  70
anonymous Reactive follicular hyperplasia with granulomas, suggestive of toxoplasmosis. (100%) Correlate with serology (IgM antibodies to Toxoplasma gondii). Grocott stain would be performed to exclude fungal infection. Ziehl-Neelsen stain would be performed to look for acid-fast bacilli.  100
anonymous reactive lymph node with monocytoid B-cell reaction and small epithelioid granulomas; toxoplasmosis has to be excluded (100%) correlate with serologic findings to confirm the diagnosis and to exclude other differential diagnoses such as EBV infection  100
anonymous TOXOPLASMA LYMPHADENITIS. (100% probability) Differentials would include other viral infections. Suggest correlation with toxoplasma serology, etc. nil  100
anonymous Reactive lymphoadenopathy. ? Toxoplasmosis nil  100
anonymous Toxoplasma lymphadenitis 100% Sabin-Feldman dye test, serology, indirect immunofluorescence and PCR.  100
anonymous Reactive lymphadenopathy, suggestive of Toxoplasmosis. Correlate with immunohistochemical studies and serology please.  100