A case of reticulosis, 58 years old man, was reported. The initial symptomes were fever and papuloerythematous skin eruption on trunk and extremities, followed by enlargement of cervical and axillary lymph nodes. Biopsy of a cervical lymph node was interpreted as reticulosis. Diffuse hypergammaglobulinemia was present (Fig. 1, Table 2). This was due to an increase in IgG component (Fig. 2). Peripheral blood exhibited atypical mononuclear cells resembling to so called virocytes (Table 3, Photo. 1, 2). Other laboratory findings on admission were not contributory (Table 1). A course of Sigmamycin (Tetracycline 2+Oleandomycin 1) resulted in a remarkable decrease of lymph nodes in size and peripheral atypical cells in number (Fig. 3). However, second course was necessary, that was not so effective for lymph nodes as the initial one. He died of sudden bleeding from stomach. Postmortem examination revealed systemic enlargement of the lymph nodes, splenomegaly and multiple tumors of the stomach with ulcers on their surfaces. Serial lymph node specimens, three biopsies and autopsy, demonstrated a progressively changing pattern (Photo. 3-9, 12-14). Initially diffuse proliferation of reticulum cells and increased vascularity were noted, together with many lymphogonia-like cells. Plasma cells were seen in small number. Subsequently round cells of various sizes and plasma cells increased in number, associated with fibrosis around small vessels. Finally plasma cells predominated, and a lot of multinucleated cells were noted. The normal architecture was almost obliterated. Histologic features similar to that of lymph nodes were present in tumors of the stomach (Photo. 15, 16), and also in the spleen (Photo. 17), bone marrow (Photo. 18), liver, kidneys, lungs, adrenal glands, thyroid gland and testes. The interrelationships between the pathologic findings, peripheral atypical cells and protein abnormality were discussed. In addition, on the basis of clinical and pathologic findings, a possible explanation for the cause of this disease was presented.
