Case 216. Syphilitic lymphadenitis (42 y-o M)

　 　 　 　
　
Cervical lymph node biopsied from a febrile man with a high titer of TPHA
 　
　 　 　 　

　

 　 The enlarged node is multifocally replaced by epithelioid granulomas (HE, low power). No caseous necrosis is seen. The features represent tertiary syphilis forming gumma.