Immunoblastic lymphadenopathy: evolution into immunoblastic sarcoma

A case of immunoblastic lymphadenopathy which underwent transformation into immunoblastic sarcoma is reported. A 64-year-old man presented with a rash, generalised lymphadenopathy, and hepatosplenomegaly. A cervical lymph node removed at biopsy showed the features of immunoblastic lymphadenopathy with the presence of heavy chain classes IgG, IgM, and IgA and both kappa and lambda light chain types in the cytoplasm of the immunoblasts. No such immunoglobulins could be demonstrated in the lymph nodes obtained at necropsy when the patient died of widespread immunoblastic sarcoma. The biological evolution and histogenesis of the disease are discussed and the current literature is reviewed.