Successful treatment of angioimmunoblastic lymphadenopathy with dysproteinemia by local irradiation

We report an 85-year-old man presenting with angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) of the palatine tonsil with cervical and axillary lymph node enlargement, pleural effusion and hypergammaglobulinemia. The patient was treated in Internal Medicine with combined chemotherapy with steroids which resulted in a complete remission. However, he returned almost 1 year later with an ulcerative lesion in the left palatine tonsil, with no lymph node involvement. Considering that the patient was an elderly person, chemotherapy had been administered during the initial admission, tumor cells appeared to originate from T cells and relapse occurred only in the local lesion, the lesion was treated by local irradiation using 60Co at a dose of 40 Gy, which produced a complete resolution. Radiotherapy appeared to be effective for the treatment of localized lesions of AILD.