Syphilitic Lymphadenitis: The lymph node is enlarged due to marked follicular hyperplasia. The lymphoid follicles may have bizarre shapes due to partial fusion with adjacent follicles. There may be a second row of follicles in the deep cortex. The appearance can mimic follicular lymphoma. The secondary follicles are sharply defined and contain numerous macrophages. Medullary region shows numerous plasma cells, sometimes forming solid sheets. Small non-caseating epithelioid granulomas or just naked multinucleated giant cells may be present.