Malignant progression of angioimmunoblastic lymphadenopathy.

In a 79-year-old woman, the progression of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) to malignant lymphoma was observed within one year after diagnosis. Three biopsy specimens from lymph nodes and one tonsil, obtained at intervals of several months, showed an increasing destruction of the tissue architecture and the development of histological criteria for a lymphoid neoplasm, which at autopsy was confirmed as a malignant non-Hodgkin's lymphoma. The demonstration of a chromosomally abnormal clone in lymph node derived and the laboratory findings were in agreement with the histological changes and the sequential clinical deterioation. Initially, a symptom-free interval of eight months was achieved with prednisone therapy. However, this treatment failed after the malignant transformation had become evident.