Ultrastructural study of immunoblastic lymphadenopathy

An autopsy case of angio-immunoblastic lymphadenopathy with dysproteinemia (Frizzera et al. 1917) or immunoblastic lymphadenopathy (Lukes and Tindle 1975) is reported. Clinical pictures and morphologic characteristics of affected organs were typical of this disease. In spite of combination chemotherapy, the patient took a rapid fatal course. Post-mortem examinations disclosed involvement of the lymph nodes, liver, lungs, kidneys and skin. Cellular infiltrates in the kidney were more monomorphous, suggesting the potential for the development of immunoblastic sarcoma. Electron microscopies of the affected lymph nodes revealed the proliferation of immunoblasts characterized by moderate amount of clear cytoplasm with abundant polyribosomes and by large nuclei with prominent nucleoli. Undulated tubules associated with the endoplasmic reticulum and giant mitochondria with the centrally placed cristae were observed in occasional immunoblasts. Cytoplasmic fragments of immunoblasts and filamentous material among the cells were considered to correspond to the amorphous intercellular material seen in histologic sections.