“…In addition, abnormal enlargement of lymph nodes, liver, and spleen, separately or together, have been reported in some cases of the acquired deficiency only (Rohn et al, 1955;Good and Mazzitello, 1956;Citron, 1957); and, occasionally, a thymoma has been discovered (Good and Varco, 1955;Martin et al, 1956;MacLean et al, 1956;Ramos, 1956), removal of which did not alter the serum y-globulin level in one patient (MacLean et al, 1956). Such abnormalities were not present in my patient, but they have been found associated with granuloma or tumour involvement of the reticulo-endothelial system in some patientssarcoidosis (Zinnieman et al, 1954), malignant lymphoma (Arends et al, 1954), chronic lymphatic leukaemia (Prasad and Koza, 1954;Jim and Reinhard, 1956), as well as generalized amyloidosis (Gras et al, 1954)-and it may well be that such involvement directly impairs plasma-cell function and therefore antibody formation. It is probable that acquired hypogammaglobulinaemia is more commonly due to immaturity of plasma cells, as instanced by Citron (1957), and this may be genetically determined.…”