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David Alexander Leaf, MD, MPH
University of California Los Angeles

JAMA. 1990;264(23):2993.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

The clinical diagnosis of lymphadenopathy is based on the presence of palpable lymph nodes.¹ Our study presents the first reported association between lymphadenopathy and the presence of chylomicronemia in the absence of any of the currently recognized causes of lymphadenopathy.² Contrary to Dr Cresson's belief, the histopathologic description provided in the study is taken directly from the report of a pathologist at our institution. The long-standing nature of this patient's lymphadenopathy, the extent of which fluctuated with the degree of hypertriglyceridemia, permitted a repeated biopsy that confirmed these findings.

As is shown on the electron microscopic findings, fat droplets were found within the lymph node cells. Therefore, the example of patients with breast cancer studied by Dr Cresson, as it relates to fatty infiltration that appears to be extracellular, is not relevant to our patient, especially because she did not have breast cancer. Similarly, she . . . [Full Text PDF of this Article]

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