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Indian Journal of Pathology: Research and Practice

Volume  12, Issue 3, July-September 2023, Pages 95-103
 

Review Article

Benign Epithelial Inclusions in Lymph Nodes: A Diagnostic Challenge for the Pathologists

Mukta Pujani, Cherry Bansal, Meenu Pujani

1 Professor & HOD, Department of Pathology, ESIC Medical College & Hospital, Faridabad, Haryana 121001, India, 2 Professor & HOD, Department of Pathology, Dr. S.S. Tantia Medical College, Hospital and Research Center, Sriganganagar, Rajasthan 335002, India, 3 Director, Lab, Metro Heart Institute with Multispeciality, Faridabad, Haryana 121001, India.

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DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.12323.2

Abstract

Benign inclusions are defined as foci of non neoplastic ectopic tissues in lymph nodes encompassing various types of tissues. Benign epithelial inclusions have been reported in lymph nodes of various anatomical locations including head and neck, mediastinum, axilla, peritoneal, pelvic and inguinal regions. Epithelial inclusions can be divided into epithelial, nevomelanocytic and decidual. Further subtypes based on the tissue of origin include salivary gland tissue, thyroid tissue, squamous epithelial cells, breast tissue, mesothelial cells etc. The nature of tissue in heterotopic inclusions varies according to the location of the lymph nodes. The accurate diagnosis of these benign epithelial inclusions is of utmost clinical importance to prevent misinterpretation of this entity as malignant and hence save the patient from overzealous and inappropriate treatment. Hence, great importance should be given to detailed morphological evaluation of lymph nodes with epithelial inclusions in reaching at an accurate diagnosis. The cytological criteria favouring benign epithelial inclusions over metastatic carcinoma include a lack of significant nuclear atypia, pleomorphism and hyperchromasia. It is very important to create awareness of this rare entity among pathologists to prevent misdiagnosis or overdiagnosis of a malignant lesion.


Keywords : Benign epithelial inclusions; Metastasis; Ectopic tissue; Lymph nodes.
Corresponding Author : Mukta Pujani, Professor & HOD, Department of Pathology, ESIC Medical College & Hospital, Faridabad, Haryana 121001, India.