MEDIASTINAL LYMPH-NODE ENLARGEMENT AND SPLENOMEGALY IN PRIMARY HYPOGAMMAGLOBULINEMIA

The computed tomography (CT) scans of 37 patients with primary hypogam maglobulinaemia were reviewed to determine the frequency of enlarged m ediastinal lymph nodes and splenomegaly in this group. None of the 10 X-linked Agammaglobulinaemia (XLA) patients had enlarged nodes and onl y one had splenomegaly. Eleven of the 27 Common Variable Immunodeficie ncy (CVID) group had enlarged nodes (41%) and 13 had splenomegaly (48% ). There was no significant correlation between the presence of enlarg ed nodes and splenic enlargement. Twenty-two patients had bronchiectas is but the presence of bronchiectasis did not correlate with the prese nce of either splenomegaly or lymphadenopathy. Three to 6 years follow -up is available for 36 of the 37 patients and none of this group have developed lymphoma or other malignancy. Enlarged mediastinal nodes an d/or splenomegaly are frequently. found in patients with CVID and are usually due to a benign, non-neoplastic, process. Mediastinal lymph no de enlargement is not a feature of XLA and splenomegaly is unusual in this condition.