{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:13:50Z","timestamp":1753884830688},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,5,15]],"date-time":"2013-05-15T00:00:00Z","timestamp":1368576000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Autoimmune diseases (<jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>) are associated with lymphadenopathy and splenomegaly. Changes in the spleen have not been characterized completely in <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>; we describe splenectomy specimens from five patients with chronic <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>, highlighting the presence of necrotizing histiocytosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Of the patients (three males and two females; mean 40\u00a0years), four had systemic lupus erythematosus; one had rheumatoid arthritis. All had moderate splenomegaly (213\u2013803\u00a0g, mean 421\u00a0g). Four cases exhibited necrosis with apoptosis and karyorrhectic debris occurring in the white pulp and minimal acute inflammation; one showed florid follicular hyperplasia. Splenic involvement ranged from focal to extensive. Plasma cells were negative for Ig<jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>4. Haematoxylin bodies were not identified. Stains for infectious organisms were negative. Immunohistochemical studies showed that lymphocytes surrounding the necrosis were a mixture of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4<jats:sup>+<\/jats:sup> and <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>8<jats:sup>+<\/jats:sup> T cells; <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>123\u2010positive plasmacytoid dendritic cells were not present, and staining for kappa and lambda light chains showed no clonality. 16<jats:styled-content style=\"fixed-case\">S<\/jats:styled-content> r<jats:styled-content style=\"fixed-case\">DNA PCR<\/jats:styled-content> was performed; no amplification was seen in three of four cases tested for bacteria specific r<jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>pstein\u2013<jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>arr virus\u2010encoded <jats:styled-content style=\"fixed-case\">RNA<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">EBER<\/jats:styled-content>) <jats:italic>in situ<\/jats:italic> hybridization studies highlighted rare positive cells in four cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Splenomegaly in <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> is thought to be hyperplasic, but we present four cases showing histiocytic necrosis, a finding which should be considered part of the spectrum of <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> in the spleen.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.12143","type":"journal-article","created":{"date-parts":[[2013,3,23]],"date-time":"2013-03-23T06:58:14Z","timestamp":1364021894000},"page":"19-28","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Splenic manifestations of chronic autoimmune disorder: a report of five cases with histiocytic necrotizing change in four cases"],"prefix":"10.1111","volume":"63","author":[{"given":"Aaron","family":"Auerbach","sequence":"first","affiliation":[{"name":"Joint Pathology Center Silver Spring MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas A","family":"Summers","sequence":"additional","affiliation":[{"name":"Department of Pathology Walter Reed National Military Medical Center Bethesda MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binxue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Henry M. 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