Umeno Y, Matsuishi E, Murakami Y, Nakao T, Miyamoto Y, Yoshitomi S, Irie K, Ohta Y
Department of Internal Medicine, Saga Prefectural Koseikan Hospital.
Fukuoka Igaku Zasshi. 1995 Jun;86(6):293-7.
While he was treated for macroglobulinemia showing symptoms, a 65-year-old man developed an enlargement of the left lateral cervical lymph node. Biopsy specimens of the cervical lymph node revealed large-cell non-Hodgkin's lymphoma. The lymphoma cells had rearrangement in the immunoglobulin heavy chain and kappa light chain genes. There was osteolysis involving right metatarsal bones. And, a tumor appeared on the upper hard palate in the terminal stage. Autopsy specimens showed infiltration of lymphoma cells into multiple organs. Production of monoclonal immunoglobulin M was detected only slightly and focally in the tumors. Plasmacytic differentiation as in Waldenström's macroglobulinemia was not seen in any organs except the tumor on the upper hard palate. From these findings, it is speculated that B-cell lymphoma might have developed in the course of macroglobulinemia.
一名65岁男性在接受有症状的巨球蛋白血症治疗时，左侧颈部淋巴结肿大。颈部淋巴结活检标本显示为大细胞非霍奇金淋巴瘤。淋巴瘤细胞的免疫球蛋白重链和κ轻链基因发生重排。右跖骨出现骨质溶解。并且，在终末期硬腭上部出现肿瘤。尸检标本显示淋巴瘤细胞浸润多个器官。仅在肿瘤中轻微且局灶性地检测到单克隆免疫球蛋白M的产生。除硬腭上部的肿瘤外，在任何器官中均未见到如华氏巨球蛋白血症中的浆细胞分化。根据这些发现，推测B细胞淋巴瘤可能在巨球蛋白血症病程中发生。
