Resegotti L, Ruà S, Dolci C, Grosso B, Pistone M, Testa D
Acta Haematol. 1983;70(1):54-8. doi: 10.1159/000206689.
A case is reported of an elderly patient with generalized lymphadenopathy who, at presentation, showed a blood and bone marrow picture suggestive of plasma cell leukemia, polyclonal hypergammaglobulinemia restricted almost exclusively to IgA, and severe renal insufficiency. Treatment with melphalan and prednisone produced a complete remission that lasted only 1 month. A second partial remission was obtained, but the patient eventually died of heart failure. The pathological picture of the lymph nodes and spleen was intermediate between that of angioimmunoblastic lymphadenopathy (AIL) and of the plasma cell type of giant lymph node hyperplasia (Castleman's disease). The hypothesis is presented that AIL, Castleman's disease and many other polyclonal lymphadenopathies recently described in immunodeficient or elderly patients, including the present case, represent a continuous spectrum of lymphoproliferative disorders due to abnormal responses to various stimuli.
报告了一例老年患者，其表现为全身淋巴结肿大，就诊时血液和骨髓检查结果提示浆细胞白血病、几乎仅局限于IgA的多克隆高球蛋白血症以及严重肾功能不全。美法仑和泼尼松治疗使患者完全缓解，但仅持续1个月。随后获得了第二次部分缓解，但患者最终死于心力衰竭。淋巴结和脾脏的病理表现介于血管免疫母细胞性淋巴结病（AIL）和浆细胞型巨大淋巴结增生（卡斯尔曼病）之间。提出的假说为，AIL、卡斯尔曼病以及免疫缺陷或老年患者中最近描述的许多其他多克隆淋巴结病（包括本病例），代表了由于对各种刺激的异常反应而导致的一系列连续的淋巴增殖性疾病。
