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Correspondence
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Volume 349:407-408 July 24, 2003 Number 4
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CD8+ T Lymphocytes in Bronchiolitis Obliterans, Paraneoplastic Pemphigus, and Solitary Castleman's Disease

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To the Editor: Paraneoplastic pemphigus has been reported in patients with Castleman's disease, and bronchiolitis obliterans in association with paraneoplastic pemphigus can eventuate in respiratory failure and death.1,2,3,4 Anatomically, there is a diffuse segmental constrictive bronchiolitis of small bronchioles.5 The cause of the bronchiolitis is obscure. Acantholysis of bronchial epithelium and linear deposition of IgG and complement along the lamina propria were observed on transbronchial biopsy in two patients,2 suggesting that autoantibodies may have a role.

A 52-year-old man presented with abdominal discomfort in December 1999. Computed tomography (CT) of the abdomen revealed a retroperitoneal mass, 12x8x. . . [Full Text of this Article]



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