Syphilitic lymphadenopathy may be localized or generalized.
Histologic features:
(1) follicular hyperplasia
(2) interfollicular plasmacytosis
(3) capsular and trabecular fibrosis with a plasma cell infiltrate
(4) variable endarteritis or venulitis with plasma cells
Less common findings may include:
(1) clusters of epithioid histiocytes
(2) sarcoid-like granulomas
(3) suppurative granulomas
(4) necrotizing lymphadenitis
Diagnosis is supported by:
(1) a positive serology test
(2) spirochetes visualized on silver or immunohistochemical stains
Differential diagnosis:
(1) rheumatoid arthritis or other autoimmune disorder
(2) malignant lymphoma
(3) other conditions associated with follicular hyperplasia
