Immunoblastic lymphadenopathy-like T cell lymphoma evolving into a massiveplasma cell proliferation with biclonal paraproteinemia

We present a case of immunoblastic lymphadenopathy-like T cell lymphoma (IB L-T) who subsequently developed a massive proliferation of plasma cells. At diagnosis of IBLT, the patient had polyclonal hypergammaglobulinemia and s ubsequently, while on chemotherapy, developed paraproteinemia with biclonal peaks and the IBLT lesion was replaced with a massive proliferation of CD3 8-positive plasma cells. The evolution was not likely to be attributed to a new neoplastic proliferation of B cells. It appeared that two B cell clone s possibly had a growth advantage among the polyclonal B cells due to a dep letion of suppressor T cells or to a disturbance in the immune system.