Anubha Bajaj*

Department of Histopathology, Panjab University/A.B. Diagnostics, India

*Corresponding Author: S Sheeba, Department of Obstetrics and Gynaecology, Sarada Krishna Homoeopathic Medical College, (Affiliated to The Tamil Nadu Dr. M.G.R. Medical University, Chennai), Kulasekharam, Kanyakumari District, Tamilnadu, India.

Received: January 30,2026; Published: February 01, 2026

Abstract

Lymphadenitis arising due to Whipple’s disease is exceptionally observed and occurs on account of infection with Tropheryma whipplei. The microorganism is commonly encountered within farmers and outdoor employees immersed in soil and sewage work. However, animals appear to lack the bacterial congregation. Clinically, symptoms such as diarrhoea, malabsorption, weight loss, pyrexia and arthralgia may ensue. Occasionally, cardiac symptoms or involvement of central nervous system (CNS) may be observed. The bacteria may engender significant enlargement of mesenteric and periaortic lymph nodes wherein enlargement of peripheral lymph nodes appears as a preliminary symptom [1,2]. Characteristically, Tropheryma whipplei infection represents with antecedent, frequently discerned arthralgia (~90%), weight loss, diarrhoea and abdominal pain [1,2]. Whipple’s disease may represent with varied multi-organ manifestations as endocarditis, lymphadenopathy, cough, pleural effusion or malabsorption syndrome [1,2]. Endocarditis with triple valve involvement as aortic valve, mitral valve or tricuspid valve occurs due to Tropheryma whipplei infection which is non discernible by culture. Aortic vegetation may concur with involvement of aortic, tricuspid and mitral valves [3,4]. Tropheryma. whipplei infection may preponderantly represent with isolated endocarditis in the absence of various clinical manifestations. Up to 60% subjects with Whipple’s disease may represent with lymphadenopathy, thereby necessitating demarcation from gastrointestinal lymphoma. Mesenteric and pulmonary hilar or mediastinal lymphadenopathy is commonly observed. Retroperitoneal and peripheral, axillary or inguinal lymphadenopathy may emerge as a singular manifestation [3,4]. Whipple’s disease with pulmonary involvement may induce chronic cough. Subjects with Whipple’s disease may represent with weight loss, decimated serum albumin, iron deficiency anaemia, vitamin and mineral deficiencies as vitamin D deficiency and zinc deficiency secondary to malabsorption [3,4]. Upon microscopy, lymph node architecture is obscured and riddled with disseminated, poorly defined lipo-granulomas. Lymph node sinuses are pervaded with macrophages impregnated with foamy cytoplasm. Macrophages are permeated with bacilli which may be highlighted by periodic acid Schiff’s (PAS+) stain with diastase resistance. Ultrastructural examination expounds rod-like bacilli [3,4].

References

1. Rutherford V and Afroze A. “From Symptoms to Solution: A Diagnostic Challenge of Whipple's Disease”. Cureus4 (2025): e81767.
2. Cappellini A., et al. “Whipple's disease: a rare disease that can be spotted by many doctors”. European Journal of Internal Medicine 121 (2024): 25-29.
3. Krüger SR., et al. “Generalized lymphadenopathy due to Tropheryma whipplei: thinking outside the box!”. International Journal of Infectious Diseases 143 (2024): 107033.
4. Deng Y., et al. “Whipple's disease of the respiratory system: a case report”. Experimental and Therapeutic Medicine 27 (2024): 133.
5. Krug A., et al. “Novel T Follicular Helper-like T-Cell Lymphoma Therapies: From Preclinical Evaluation to Clinical Reality”. Cancers (Basel)10 (2022): 2392.
6. Wang L., et al. “Primary cutaneous peripheral T-cell lymphomas with a T-follicular helper phenotype: an integrative clinical, pathological and molecular case series study”. British Journal of Dermatology6 (2022): 970-980.
7. Melas N., et al. “Whipple's disease: the great masquerader-a high level of suspicion is the key to diagnosis”. BMC Gastroenterology 21 (2021): 128.
8. Kucharz EJ., et al. “Clinical manifestations of Whipple's disease mimicking rheumatic disorders”. Reumatologia 59 (2021): 104–110.
9. McGee M., et al. “Tropheryma whipplei endocarditis: case presentation and review of the literature”. Open Forum Infectious Diseases 6 (2019).
10. Image 1 Courtesy: Science direct.
11. Image 1 Courtesy: Pathology outlines.

Citation

Citation: Anubha Bajaj. “Purge and Ouster-Whipple Disease Lymphadenitis". Acta Scientific Gastrointestinal Disorders 9.2 (2026): 01-03.

Copyright

Copyright: © 2026 Anubha Bajaj. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.