A 76-year-old man was admitted to our hospital because of generalized lymphadenopathy and skin rash in February, 1983. Laboratory examinations showed pancytopenia, hypocellular marrow, polyclonal hypergammaglobulinemia and predominant helper/inducer T lymphocyte in peripheral blood and in lymph node. Histological finding of the cervical lymph node was immunoblastic lymphadenopathy. After four months, subjective symptoms and laboratory findings were spontaneously improved following the stop of Eviprostat. In February, 1985, he was re-admitted because of generalized lymphadenopathy. Biopsy of the inguinal lymph node revealed malignant lymphoma, diffuse, large, clear cell type. Several courses of CHOP therapy (cyclophosphamide, adriamycin, vincristine, prednisolone) resulted in the improvement of generalized lymphadenopathy. In October, 1985, generalized lymphadenopathy re-appeared, and skin tumor of the back was developed in December. Immunohistological examination of biopsied skin tumor showed malignant lymphoma, diffuse, medium-sized, B cell type. He was treated with CHOP therapy, but died in January 1986. We reported a case of immunoblastic lymphadenopathy terminating in B cell lymphoma through the phase of clear cell lymphoma, and discussed the mechanism of malignant evolution.
