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Pathology/biopsy of axillary lymph node


Hi Doctor:
my husband's 4 x 3.3 x 2 cm axillary lymph node biopsy came out as reactive hyperplasia after doing an immunohistochemical stain: initial result was atypical lymphoid proliferation, my questions as follow:

1. is it possible that there are exsiting lymphoma nodes but the node that was taken out is benign?  the surgeon said normally the biggest node (4 cm)  is the most susupicious one thats why he took that for biopsy, and it was palpable.  the rest are smaller  ranging from 1.5cm to 3 cm and not palpable.

2. will reactive hyperplasia turn into lymphoma someday?  is my husband at risk to develop lymphoma since he has reactive hyperplasia?

3. he used to smoke electronic cigarette which uses "e cigarette juice" with different flavors like coffee etc, is it possible that the toxins of the chemicals used in the e cigarette went to his lymph gland thus causing reactive nodes?

my husband is 44 years old, chest xray, blood work including LDH cbc etc within normal limits (no sign of infection), abdominal ultrasound clear, no organs are enlarged, and he doesnt have the classic "B" symptoms such as  night sweat, weight loss, fever etc.

please advise, thank you very much

Hello Jeanne

The standard of care is to remove the largest node, the small ones may not show anything. If there is lymphoma, cancer or infection it grows by replacing the normal cells in the nodes which enlarges the node.

Reactive hyperplasia means the node has increased in size by increased growth of cells which are responding to some agent - most likely chronic or acute infection or irritation. Long term smoking, repeated sore throat , cough, etc can cause this.

It is unlikely that this turns into lymphoma. However, he has the Sam e risk as general population for lymphoma. Reactive hyperplasia does not add to the risk.

All other investigations do not point to a lymphoma. But if the other nodes continue to increase in size they need to be evaluated.


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Neha Dahiya MD


Help patients understand the medical terminology of their lab results and / or tissue biopsy reports.


I am a pathologist and director of clinical laboratory services. I have been a practicing pathologist for last 9 years in a 350 bed multi specialty hospital laboratory in India.

Indian association of pathologists and microbiologists.
International Academy of Cytology
International association of Pathologists - Indian division
Indian association of Cytology

MD (pathology) MBA

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