Immunoblastic lymphadenopathy: failure of, rather than lack of immunoregulation

The lymphoid proliferation characteristic of immunoblastic lymphadenopathy is polyclonal and of B cell lineage. This proliferation of B cells could result from an inherent B cell defect, prolonged and pronounced antigenic stimulation, or inadequate immunoregulation. We recently evaluated a patient with this disorder and found excessive T cell mediated in vitro suppression of both the autologous and allogeneic blastogenic response to mitogen. This enhanced in vitro suppression suggests that the clinically observed lymphoid proliferation in this patient occurred because of autonomous or excessively stimulated B cells and not because of a lack of functional suppressor cells.