A patient presented with fever, night sweats, generalized lymphadenopathy, cold agglutinin hemolytic anemia, and thrombocytopenia. Lymph node biopsy revealed a lymphoplasmacytic infiltrate sparing the cortical sinuses but associated with arborizing blood vessels. Epstein-Barr virus (EBV) DNA was demonstrated in tissue from an involved lymph node. These data suggest an association of EBV with a lymphoproliferative process that resembles angioimmunoblastic lymphadenopathy with dysproteinemia.