ANGIO-IMMUNOBLASTIC LYMPHADENOPATHY WITH DYSPROTEINÆMIA

A new disease with a lymphoma-like Summary clinical presentation and a specific histological picture has been recognised in fifteen patients. Clinically, the disease, which seems to occur chiefly in the elderly, is characterised by an acute onset of constitutional symptoms, generalised lymphadenopathy, hepatosplenomegaly, and immunological abnormalities. The course is stormy, but in one third of the reported cases it may have been controlled by immunosuppressants; severe infectious complications are common and often fatal. Histologically, diffuse obliteration of the nodal architecture due to pronounced proliferation of small vessels and immunoblasts is the distinctive feature; there is similar proliferation in the spleen, bone-marrow, liver, and skin. Biopsy specimens and necropsy material indicate that the disease is a non-neoplastic process. The histological evolution, the widespread organ involvement, and the clinical pattern are very similar to those of a graft-versus-host reaction.