The authors describe the clinical and radiographic features in 7 patients with angioimmunoblastic lymphadenopathy (AIL) with dysproteinemia. This condition should be considered in any patient over 50 who presents with constitutional symptoms such as fever, weight loss, and malaise accompanied by involvement of the peripheral and hilar or mediastinal lymph nodes. Contrary to previous reports, the anterior mediastinal nodes may be involved. Intrapulmonary masses accompanied by clinical deterioration may indicate transformation to immunoblastic lymphoma. The gallium scans and radiographic appearance assist in the diagnosis, but lymph node biopsy is necessary in order to distinguish AIL from lymphoma.