Adachi Yuichi, Takimoto Takayuki, Takeda Maiko, Matsumoto Kinnosuke, Takeuchi Naoko, Kagawa Tomoko, Sakamoto Tetsuki, Kasai Takahiko, Sugimoto Chikatoshi, Inoue Yasushi, Tachibana Kazunobu, Arai Toru, Inoue Yoshikazu
Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, 1180 Nagasone-Cho, Kita-Ku, Sakai City, Osaka, 591-8555, Japan.
Department of Pathology, National Hospital Organization Kinki-Chuo Chest Medical Center, 1180 Nagasone-Cho, Kita-Ku, Sakai City, Osaka, 591-8555, Japan.
Respir Med Case Rep. 2020 Dec 1;31:101313. doi: 10.1016/j.rmcr.2020.101313. eCollection 2020.
A 60-year-old man was admitted for ground glass opacity in the lower lung field and mediastinal lymphadenopathy. Blood tests revealed elevated serum IgM levels, and the urine test detected Bence-Jones protein. Surgical biopsy from the mediastinal lymph node and lung showed small lymphocytes and plasma cells between follicles, and AL kappa amyloid deposition. Genetic examination detected L265P mutation. Our diagnosis was lymphoplasmacytic lymphoma (LPL), involving the mediastinum and the lung, followed by amyloidosis. Mutation analysis, in addition to conventional histological evaluation, was useful for a precise diagnosis.
一名60岁男性因下肺野磨玻璃影及纵隔淋巴结肿大入院。血液检查显示血清IgM水平升高，尿液检查检测到本周氏蛋白。纵隔淋巴结和肺部的手术活检显示滤泡间有小淋巴细胞和浆细胞，以及ALκ淀粉样蛋白沉积。基因检测发现L265P突变。我们的诊断是淋巴浆细胞淋巴瘤（LPL），累及纵隔和肺部，继发淀粉样变性。除了传统的组织学评估外，突变分析有助于精确诊断。
