Cat scratch disease (CSD) is caused by Bartonella henselae. The histological appearance of lymph node biopsy in CSD shows:

• A Stellate microabscesses with palisading histiocytes ✓
• B Caseating granulomas with Langhans giant cells
• C Reed-Sternberg cells within a mixed inflammatory background
• D Non-caseating granulomas with asteroid bodies

Explanation

The characteristic lymph node histology of CSD consists of necrotizing granulomas with stellate (star-shaped) central microabscesses surrounded by palisading epithelioid histiocytes — a pattern called 'stellate granuloma with microabscess.' Warthin-Starry silver stain can demonstrate pleomorphic gram-negative rods (Bartonella) within the granuloma. Caseating granulomas are typical of tuberculosis; Reed-Sternberg cells indicate Hodgkin lymphoma; non-caseating granulomas with asteroid bodies characterise sarcoidosis. CSD is a benign self-limiting infection but diagnosis avoids unnecessary malignancy workup.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

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