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Cat-Scratch Lymphadenitis A low power view of a hyperplastic follicle below an area of monocytoid B-cell hyperplasia with early necrosis. This is an early stage in the disease, before the formation of large, stellate, clearly suppurative granulomas. Left: A medium power view of an early granulomatous area. Monocytoid B-cells can be made out at the lower left. Right: A high-power view of the monocytoid B-cells intermingled with neutrophils and some nuclear debris--harbingers of the necrosis soon to develop. From a different case, a stellate granuloma in a late stage of infection. Especially if the central necrosis has become caseous, this granuloma might be hard to distinguish from an atypical mycobacterial granuloma. Table of Contents