Atypical Lymphoplasmacytic and Immunoblastic Proliferation in Lymph Nodes of Patients with Autoimmune Disease (Autoimmune-Disease-Associated Lymphadenopathy)

作者：Bharat N. Nathwani, Carl D. Winberg, L. Robert Hill, Henry Rappaport, Chae H. Koo · 发表于：Medicine · 年份：1984 · DOI：10.1097/00005792-198409000-00002 · 被引用次数：79 · 研究领域：Autoimmune Bullous Skin Diseases、Vascular Tumors and Angiosarcomas、Chronic Lymphocytic Leukemia Research

This study is based on an analysis of the morphologic, clinical, and laboratory findings in 26 patients whose pretherapy lymph node biopsies showed some, but not all, of the diagnostic features of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD). Partial or complete effacement of nodal architecture by a diffuse lymphoplasmacytic and immunoblastic proliferation was a constant histologic finding. In contrast to the findings in AILD, lymphocytic depletion and pronounced arborizing vascular proliferation were often lacking. Clinically, many of the patients had fever, sweats, weight loss, skin rashes, generalized lymphadenopathy, hepatosplenomegaly, and, in some cases, pulmonary infiltrates. Of the 26 patients, 23 had clinical and/or laboratory evidence of autoimmune disease or immune complex disease. In 12 patients (Group I--idiopathic), various autoantibodies or immune complexes were demonstrable, but these patients did not manifest a well-defined immunologic disease or syndrome. In 11 patients (Group II--secondary), the lymphadenopathy occurred secondary to a well-defined, clinically recognized immunologic disease. Three patients (Group III) had neither a well-defined autoimmune disease nor demonstrable autoantibodies, but two of them had a history of exposure to antibiotics. We suggest that patients whose lymph nodes have the morphologic features described here frequently have an autoimmune disorder, and that the pathogenesis of this clinicopathologic picture is p...