Immunoblastic lymphoma and thymic epithelial hyperplasia in angioimmunoblastic lymphadenopathy following gold therapy

A 62-year-old woman with well-established polyarthritis developed angioimmunoblastic lymphadenopathy (AILD) during gold therapy. She subsequently developed an immunoblastic lymphoma which showed monoclonality (IgA, lambda) by immunoperoxidase techniques. There was a tumor-like enlargement of the thymus gland due to involvement by AILD, with secondary proliferation of thymic epithelium. The finding of thymic involvement, which has not been described previously in AILD, might be one of the manifestations reflecting a disturbance of the immune system in this disease.