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July 3, 1948


Author Affiliations

New York

From the Department of Radiation Therapy, Bellevue Hospital, New York, Dr. Ira I. Kaplan, Director. Dr. Rubenfeld is visiting radiation therapist, Bellevue Hospital; and associate clinical professor of radiology, New York University College of Medicine.

JAMA. 1948;137(10):849-853. doi:10.1001/jama.1948.02890440025005

There is a comparatively newly described disease which is known as giant follicular lymphadenopathy or Brill-Symmers disease.1 It has been widely recognized by pathologists but is only beginning to attract the attention of clinicians, among whom it is almost always mistaken for Hodgkin's disease. Both are primarily diseases of the lymphoid system and both are characterized, clinically, by generalized, occasionally by localized, enlargement of the superficial lymph nodes and not uncommonly by splenomegaly. Histologically, the changes in the lymph nodes and the spleen are so divergent that confusion between the two diseases is scarcely possible. It is imperative for the radiologist, to whom falls the duty of treating these patients, to know the underlying morphology and the responses to radiation. Giant follicular lymphadenopathy is characterized by numerical and dimensional hyperplasia of the lymph follicles (fig. 1). The follicles may consist exclusively of small lymphocytes (fig. 2). More commonly three

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