Fever of unknown origin due to inflammatory pseudotumour of lymph nodes

The clinical features of inflammatory pseudotumour of lymph nodes, a distin ct non-malignant histopathological entity firstly described in 1988, are su mmarized based upon a detailed analysis of 4 personal cases and 47 cases re ported in the literature. The mean age of the patients is 38 years (range 8 to 82 years) and there is no gender predilection. One third present with a symptomatic lymphadenopathy and 47% present with fever, nearly all meeting the criteria of fever of unknown origin. Abdominal complaints are occasiona lly present. Intermittence of symptoms is common. Hepatosplenomegaly is unu sual. All lymph node areas may be involved but abnormalities are mostly con fined to one or two anatomic regions. No extranodal involvement has been re ported although inflammatory pseudotumour may occur in several organs with similar morphological features and identical signs of inflammations. Routin e blood tests are normal except for signs of inflammation. The lesions are Gallium-avid. Diagnosis is based upon typical histopathological features. T he prognosis is favorable and surgical resection frequently leads to cure. Spontaneous resolution of symptoms has been reported and nonsteroidal anti- inflammatory drugs may suppress the clinical manifestations.