Department of Pathology and Laboratory Medicine, Boston University Medical Center, One Boston Medical Center Place, Boston, MA 02118, USA.
Clin Chim Acta. 2012 Oct 9;413(19-20):1696-9. doi: 10.1016/j.cca.2012.04.020. Epub 2012 Apr 25.
Gamma heavy chain disease with underlying thyroid pathology is rare. There are 5 reported cases in the English literature, including the present case of an elderly female with γ heavy chain disease with underlying lymphoplasmacytic lymphoma of the thyroid who initially presented with long-standing goiter and chronic thyroiditis.
The protein studies and histopathologic findings in her thyroid are described. Her case is compared with reported cases of γ heavy chain disease with thyroid involvement.
Initial impression on most cases was chronic thyroiditis; however pathology showed 3 cases with plasmacytoma and 2 with lymphoplasmacytic infiltrate. All were diagnosed and followed up using serum and urine electrophoresis.
Gamma heavy chain disease has a protean manifestation; however there appears to be a more uniform pattern of the disease when it is associated with the thyroid. The inclusion of protein studies in cases diagnosed with chronic thyroiditis by FNA may aid in establishing γ heavy chain disease with underlying thyroid involvement. In this case serum and urine electrophoresis, and immunofixation studies which are simple and affordable tests facilitated the hematologic workup and follow up.
伴有甲状腺病变的γ重链病很少见。在英文文献中有 5 例报道，包括本例老年女性γ重链病伴甲状腺淋巴浆细胞淋巴瘤，最初表现为长期甲状腺肿和慢性甲状腺炎。
描述了她甲状腺的蛋白研究和组织病理学发现。将她的病例与报道的伴有甲状腺受累的γ重链病病例进行比较。
大多数病例的最初印象是慢性甲状腺炎；然而，病理显示 3 例为浆细胞瘤，2 例为淋巴浆细胞浸润。所有病例均通过血清和尿液电泳进行诊断和随访。
γ重链病表现多样；然而，当它与甲状腺相关时，疾病似乎呈现出更统一的模式。在通过细针抽吸细胞学诊断为慢性甲状腺炎的病例中进行蛋白研究可能有助于确定伴有甲状腺受累的γ重链病。在这种情况下，血清和尿液电泳以及免疫固定研究等简单且经济实惠的检查有助于血液学检查和随访。
