Levine A M, Lichtenstein A, Gresik M V, Taylor C R, Feinstein D I, Lukes R J
Br J Haematol. 1980 Oct;46(2):225-33. doi: 10.1111/j.1365-2141.1980.tb05961.x.
As first suggested by Lukes & Collins (1975), and recently confirmed in the literature, the pathological lesion associated with Waldenström's macroglobulinaemia can be found in patients with serum IgG or IgA monoclonal proteins. To expand upon the clinical and immunologic spectrum of this lesion, we reviewed the records of 12 patients with identical tumour morphology, though lacking an IgM paraprotein. The median age of the patients was 62 years. In five patients the tumour secreted monoclonal IgG, while one secreted monoclonal IgA. One patient had normal serum protein electrophoresis, although monoclonal light chains were demonstrated on urinary protein electrophoresis. The remaining patients had no detectable monoclonal protein. Marker studies demonstrated the B cell origin of tumour, these findings were consistent with the monoclonal protein secreted. Clinically, these cases varied, from peripheral blood involvement resembling chronic lymphocytic leukaemia, to typical lymphomatous processes, to presentations resembling multiple myeloma, reflecting the similarity of all of these conditions as varying expressions of neoplasia of the B cell system.
正如卢克斯和柯林斯（1975年）首次提出的，并在最近的文献中得到证实，与华氏巨球蛋白血症相关的病理损害可在血清IgG或IgA单克隆蛋白的患者中发现。为了进一步拓展这种损害的临床和免疫学范围，我们回顾了12例肿瘤形态相同但缺乏IgM副蛋白的患者的记录。患者的中位年龄为62岁。5例患者的肿瘤分泌单克隆IgG，1例分泌单克隆IgA。1例患者血清蛋白电泳正常，尽管尿蛋白电泳显示有单克隆轻链。其余患者未检测到单克隆蛋白。标记研究证明肿瘤起源于B细胞，这些发现与所分泌的单克隆蛋白一致。临床上，这些病例各不相同，从类似慢性淋巴细胞白血病的外周血受累，到典型的淋巴瘤过程，再到类似多发性骨髓瘤的表现，反映了所有这些情况作为B细胞系统肿瘤形成的不同表现形式的相似性。
