Registry of angiofollicular lymph node hyperplasia.

Abstract

To the Editor.— A registry of cases of localized and multicentric angiofollicular lymph node hyperplasia (AFH) has been established at the University of Nebraska Medical Center, Omaha. Localized AFH (Castleman's disease) is thought to be a benign process that occurs as solitary lymphoid mass in young patients (median age, 23.5 years). These patients are usually cured of the disorder by local excision of the mass. Recently, a multicentric form of AFH with significant patient morbidity and mortality has been reported. 1,2 Patients with multicentric AFH are generally older (median age, 56 years), and they frequently have constitutional symptoms, generalized lymphadenopathy, hepatosplenomegaly, anemia, polyclonal hypergammaglobulinemia, and bone marrow plasmacytosis. Patients with multicentric AFH can be placed into three different clinical groups based on their presentation and course: stable disease, chronic relapsing disease, and aggressive disease. 2 Patients with multicentric AFH appear to be predisposed to the development of opportunistic infections, malignant lymphoma,