Nuclear fragmentation and epithelioid change of germinal centers in the lymphoid tissue of child deaths.

Two hundred postmortems were studied retrospectively to assess the frequency of nuclear fragmentation (NF) and epithelioid change (EC) in the germinal centers of lymphoid tissues in children. Sections of spleen, mesenteric lymph node, tonsils, and appendix were included in the survey. Thirty-seven of 200 cases (18.5%) showed NF or EC or a combination. These morphological changes were considered to represent different stages of a common pathological reaction for which a classification is proposed. The type of lymphoid change correlated approximately with the duration of the preceding illness. Although more common between the ages of 1 and 3 years, they were found to extend throughout the age range studied. There was a negative correlation between the presence of NF and EC and the cause of death, but a significant association with clinical documentation of shock was present, supporting previous evidence that shock is the significant factor in pathogenesis.