Angiofollicular lymph node hyperplasia and peripheral neuropathy: association with monoclonal gammopathy

An elderly man was found to have the plasma cell variant of angiofollicular lymph node hyperplasia. His course was complicated by peripheral neuropathy and generalized lymphadenopathy, which improved after a trial of corticosteroid therapy. Although the plasma cell variant has been associated with multiple systemic effects, including the nephrotic syndrome, growth failure, fever, hyperglobulinemia, and anti-erythropoietin-mediated anemia, concurrent peripheral neuropathy has only occasionally been reported. Angiofollicular lymph node hyperplasia should be included in the differential diagnosis of peripheral neuropathy associated with lymphadenopathy or a mediastinal mass. A discussion of the clinical, histologic, and immunopathologic characteristics of angiofollicular lymph node hyperplasia is presented.