Nehashi Y, Nakano M, Utsumi K, Ichinose Y, Toyama K
First Department of Internal Medicine, Tokyo Medical College, Japan.
Intern Med. 1993 Jun;32(6):480-3. doi: 10.2169/internalmedicine.32.480.
A 69-year-old woman was examined due to abnormal pulmonary shadows on her chest roentgenogram. Although small lymphocyte proliferation was revealed in specimens by transbronchial lung biopsy (TBLB), immunoglobulin light chain restriction could not be seen. We attempted to verify the B-cell clonality by broncho-alveolar lavage (BAL) and a new sensitive method called kappa-lambda imaging (KLI), which was available for the detection of monoclonal B cells. Therefore, B-cell monoclonality was found. Thus, the patient was diagnosed as having primary pulmonary lymphoma (PPL). PPL may be differentiated from benign lymphoproliferative disorders such as pseudolymphoma and lymphocytic interstitial pneumonia by KLI of BAL-derived lymphocytes.
一名69岁女性因胸部X线片显示肺部阴影异常而接受检查。经支气管肺活检（TBLB）标本显示有小淋巴细胞增殖，但未见免疫球蛋白轻链限制。我们试图通过支气管肺泡灌洗（BAL）和一种名为κ-λ成像（KLI）的新的敏感方法来验证B细胞克隆性，该方法可用于检测单克隆B细胞。因此，发现了B细胞单克隆性。于是，该患者被诊断为原发性肺淋巴瘤（PPL）。通过对BAL来源淋巴细胞进行KLI，PPL可与良性淋巴增殖性疾病如假性淋巴瘤和淋巴细胞间质性肺炎相鉴别。
