Immunoblastic lymphadenopathy. A report of two cases.

Two patients who had immunoblastic lymphadenopathy with clinical symptoms of fever, anemia, hypergammaglobulinemia, and enlarged lymph nodes were treated with chemotherapy. The lymph node biopsy specimens were originally interpreted as malignant processes because of severe immunoblastic and plasmacytic infiltration that practically obliterated the architecture of the lymph nodes. One patient recovered and was free of symptoms five years after clinical onset of the disease. The second patient died of massive gastrointestinal bleeding six weeks after the onset of disease and five weeks after administration of cytotoxic drug therapy. The cases illustrate the ineffectiveness and possible adverse effect of chemotherapy, as well as the importance of differentiation of immunoblastic lymphadenopathy from frankly malignant lymph node diseases.