[初诊时合并骨髓纤维化和巨球蛋白血症的滤泡性淋巴瘤]

[Follicular lymphoma complicated with myelofibrosis and macroglobulinemia at initial presentation].

作者信息

Kuroda Hiroyuki, Abe Tomoyuki, Jomen Wataru, Yoshida Masahiro, Matsuno Teppei, Sato Masanori, Yamada Michiko, Sakurai Tamaki, Fujii Shigeyuki, Maeda Masahiro, Fujita Miri, Nagashima Kazuo, Murase Kazuyuki, Kato Junji

机构信息

Department of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital.

出版信息

Rinsho Ketsueki. 2013 Nov;54(11):2068-73.

PMID:24305541

Abstract

A 49-year-old woman presented with pharyngeal and cervical lymph node swelling in December 2010. Biopsy of the pharynx demonstrated follicular lymphoma which secreted large volumes of immunoglobulin M (IgM) and transforming growth factor-β (TGF-β). Bone marrow aspiration yielded a dry tap, and bone marrow biopsy demonstrated myelofibrosis associated with lymphoma cells on admission. The plasma concentration of TGF-β was elevated and monoclonal IgM gammopathy was detected. After only one course of chemotherapy with CHOP plus rituximab, remission of both lymphoma and myelofibrosis was achieved. Bone marrow aspiration became possible, and TGF-β and IgM levels normalized. Thus, the myelofibrosis was reversible.

摘要

一名49岁女性于2010年12月出现咽部和颈部淋巴结肿大。咽部活检显示为滤泡性淋巴瘤，该淋巴瘤分泌大量免疫球蛋白M（IgM）和转化生长因子-β（TGF-β）。骨髓穿刺干抽，入院时骨髓活检显示存在与淋巴瘤细胞相关的骨髓纤维化。TGF-β血浆浓度升高，检测到单克隆IgM丙种球蛋白病。仅接受一个疗程的CHOP加利妥昔单抗化疗后，淋巴瘤和骨髓纤维化均获缓解。骨髓穿刺可行，TGF-β和IgM水平恢复正常。因此，骨髓纤维化是可逆的。