Mattila J, Alavaikko M, Järventie G, Lehtinen M, Pitkänen R
Virchows Arch A Pathol Anat Histol. 1980;389(2):241-51. doi: 10.1007/BF00439489.
A 54-year-old woman had a marked splenomegaly, diarrhoea and abdominal cramps. Her serum contained monoclonal IgM with lambda light chains, and lambda light chains were also excreted in the urine. Bone marrow and spleen punctures failed to reveal the classic morphological changes associated with Waldenström's macroglobulinemia. A peroral jejunal biopsy disclosed homogenous extracellular material consisting of IgM, lambda and kappa light chains were demonstrable in a large number of the plasma cells and plasmacytoid cells in post-mortem specimens of bone marrow, spleen and some lymph nodes by the peroxidase-anti-peroxidase techniques. The causes of the "discrepancy" between the serum findings and tissue findings are discussed.
一名54岁女性出现明显脾肿大、腹泻和腹部绞痛。其血清中含有单克隆IgM及λ轻链，尿液中也排泄出λ轻链。骨髓穿刺和脾穿刺均未发现与华氏巨球蛋白血症相关的典型形态学改变。经口空肠活检发现均质的细胞外物质，由IgM、λ和κ轻链组成，通过过氧化物酶-抗过氧化物酶技术在骨髓、脾脏及一些淋巴结的尸检标本中的大量浆细胞和浆细胞样细胞中得以证实。文中讨论了血清检查结果与组织检查结果之间“差异”的原因。
