Sinus Histiocytosis with Massive Lymphadenopathy: A Case Report with Pleural Effusion and Cervical Lymphadenopathy

Sinus histiocytosis with massive lymphadenopathy (SHML) is a rare disorder characterized by a nonneoplastic proliferation of distinctive histiocyte cells within lymph node sinuses and lymphatics in extranodal sites. SHML occurs worldwide and is primarily a disease of childhood and early adulthood. A 26-yr-old man presented with painless palpable lymph node in cervical area. Radiographic studies revealed pleural effusion with lymphadenopathy and calcification in mediastinum. The cervical lymph node biopsy showed dilated sinuses filled with histiocytes with clear cytoplasm. The cells stained positive with CD68 and S-100. These cytologic and immunohistochemical findings were considered consistent with the diagnosis of SHML.

Adverse Effect of Topical Antiglaucoma Medication Conjunctival Cell Profile and Outcome of Filtration Surgery

We assessed quantitatively conjunctival biopsy specimens from 48 primary open angle glaucoma patients[62 eyes]undergoing filtration surgery by light microscopy. The patients were subdivided depending on age, sex, and their therapeutic regimen and duration before surgery. With age, there was a significant increase in lymphocytes and macrophages within the substantia propria of conjunctiva[p<0.05]. The longer the total treatment duration with topical antiglaucoma medication was, the higher the number of lymphocytes and macrophages were[p<0.05]. Whereas, when the treatment duration was adjusted, there was no significant difference between the single therapeutic regimen group and the multiple regimen group. There were some differences in the number of fibroblasts, lymphocytes and macrophages between the group that needed postoperative-antiglaucoma medication[surgical failure group]and the group without postoperative-antiglaucoma medication[surgical success group]but there were no statistically significant differences. In conclusion, administration of topical medication induced a significant degree of subclinical inflammation and change of conjunctival cell profile. However it did not depend on multiple drug regimen but on total treatment duration.