Value of lymph node biopsy in unexplained lymphadenopathy in homosexual men

The acquired immune deficiency syndrome (AIDS) manifested by severe opportunistic infections, Kaposi's sarcoma, or lymphoma often has a prodrome of lymphadenopathy accompanied by constitutional symptoms. We studied the histopathologic findings of lymph node biopsy specimens and peripheral blood immunologic parameters of 24 clinically indistinguishable homosexual men with chronic generalized lymphadenopathy. Two different morphological patterns were observed: (1) lymph nodes with follicular and paracortical hyperplasia in 21 patients who had had no clinical deterioration and (2) an atypical pattern of lymphoid proliferation in three patients who experienced rapid development of non-Hodgkin's lymphoma and/or opportunistic infections. Several immunologic laboratory results paralleled these changes. Lymph node morphological findings seem to be a useful predictor of outcome in homosexual men with generalized lymphadenopathy.