Noguchi M, Yamaguchi A, Tsuboi E, Watanabe T, Narui K, Yoshimura K, Chonabayashi N, Nakata K, Kanbayashi H, Endo Y
Department of Respiratory Disease, Immunology and Pathology, Toranomon Hospital, Tokyo.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Jan;28(1):178-82.
A case of primary macroglobulinemia with pleural and gastric involvement was presented. A 48-year-old female was admitted with productive cough. On physical examination neither lymphoadenopathy nor hepatosplenomegaly were found. In addition, no bleeding tendency nor disturbance of the visual acuity were detected. Her chest roentgenogram showed a moderate amount of pleural effusion in the left pleural cavity without infiltration in the lung fields and no evidence of swollen hilar or mediastinal lymphnodes. A monoclonal M-band of to IgM-kappa type was observed in her serum and the pleural effusion. The diffuse ulcerative lesion in the gastric mucosa was detected by gastrofiberscopy. The lymphoid cells taken from the pleural effusion and the gastric mucosa stained positively with fluorescein-conjugated antiserum to u or the kappa chain. Pleural effusion and gastric infiltration of lymphoid cells improved remarkably following ACOP therapy.
本文报告了一例伴有胸膜和胃部受累的原发性巨球蛋白血症病例。一名48岁女性因咳痰入院。体格检查未发现淋巴结肿大及肝脾肿大。此外，未检测到出血倾向及视力障碍。胸部X线片显示左胸腔有中等量胸腔积液，肺野无浸润，肺门及纵隔淋巴结无肿大迹象。血清及胸腔积液中均观察到IgM-κ型单克隆M带。经纤维胃镜检查发现胃黏膜有弥漫性溃疡性病变。从胸腔积液和胃黏膜中获取的淋巴细胞经荧光素标记的抗μ或κ链抗血清染色呈阳性。采用ACOP方案治疗后，胸腔积液及淋巴细胞对胃部的浸润明显改善。
