Mohamed G, Kochlef A, Gargouri D, Kilani A, Elloumi H, Ouakaa A, Belhadj N, Romani M, Kharrat J, Ghorbel A
Service de gastroentérologie, EPS Habib-Thameur, 1008 Tunis, Tunisie.
Rev Med Interne. 2009 Mar;30(3):279-81. doi: 10.1016/j.revmed.2008.05.018. Epub 2008 Sep 23.
The association of a monoclonal gammopathy (MG) with a B cell non-Hodgkin's lymphoma (NHL) is a well-known phenomenon. It has been recognized in many subtypes of primary gastrointestinal lymphoma but its association with primary colonic mantle cell lymphoma has never been yet described. We report a 65-year-old man who presented with an exudative ascites and constipation. Serum electrophoresis showed a monoclonal peak in the gamma region of 45g/L and immunoelectrophoresis confirmed the presence of monoclonal gammopathy of IgM kappa type. Bone marrow aspirate was normal. Radiologic and endoscopic investigations evidenced a primary colonic mantle cell lymphoma. Although the association of an MG with an NHL and, in particular, to a primitive digestive location appears a rare phenomenon, endoscopic investigations in patients with MG appears legitimate in the presence of any digestive sign.
单克隆丙种球蛋白病（MG）与B细胞非霍奇金淋巴瘤（NHL）的关联是一种众所周知的现象。它在原发性胃肠道淋巴瘤的许多亚型中已得到确认，但其与原发性结肠套细胞淋巴瘤的关联尚未见报道。我们报告一名65岁男性，表现为渗出性腹水和便秘。血清电泳显示γ区有一个45g/L的单克隆峰，免疫电泳证实存在IgM κ型单克隆丙种球蛋白病。骨髓穿刺正常。影像学和内镜检查证实为原发性结肠套细胞淋巴瘤。尽管MG与NHL的关联，尤其是与原始消化部位的关联似乎是一种罕见现象，但在MG患者出现任何消化症状时，进行内镜检查似乎是合理的。
