Giant lymph node hyperplasia: persistence of symptoms for 15 years

A woman with giant lymph node hyperplasia of the mediastinum and systemic symptoms was treated with radiotherapy. Following a short partial remission, symptoms have persisted for 15 years. Surgical excision remains the treatment of choice, although the failure of radiotherapy may be due to inadequate dosage. If symptoms persist after treatment, a diagnosis of multicentric disease should be excluded. Review of histologic material may be helpful in puzzling clinical cases, as shown by the establishment of the diagnosis in this patient 13 years after the onset of symptoms.