Chiba W, Sawai S, Ishida H, Matsui T, Matsubara Y, Ikeda S
Respiratory Disease Center, Kyoto Katsura Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Apr;31(4):506-11.
We experienced a patient with two peaks of elevated monoclonal IgM and IgA in the serum, and lambda type Bence-Jones protein in the urine. Chest X-ray films showed right pulmonary infiltrative shadow and effusion. The results of the autopsy of this patient revealed infiltration of malignant lymphoma cells in both lungs, but in no other organs. The results of immunohistochemical staining for L26. UCHL-1, IgM, IgA and lambda chain in this case led to the diagnosis of diffuse small cell type. B-cell lambda, IgM type malignant lymphoma. Gene analysis using bone marrow did not reveal any rearrangement bands for the heavy chain, light chain kappa and lambda, or TcR beta genes. Therefore, we concluded that malignant lymphoma cells had infiltrated only the bilateral lungs, causing a rare case of primary pulmonary malignant lymphoma with two monoclonal peaks of increased serum IgM and IgA.
我们遇到一名患者，其血清中出现单克隆IgM和IgA升高的两个峰值，尿液中出现λ型本周蛋白。胸部X线片显示右肺浸润性阴影及胸腔积液。该患者的尸检结果显示双肺均有恶性淋巴瘤细胞浸润，但其他器官未发现。此病例中L26、UCHL-1、IgM、IgA及λ链的免疫组化染色结果确诊为弥漫小细胞型B细胞λ、IgM型恶性淋巴瘤。使用骨髓进行的基因分析未发现重链、轻链κ和λ或TcRβ基因的任何重排条带。因此，我们得出结论，恶性淋巴瘤细胞仅浸润双侧肺，导致了一例罕见的原发性肺恶性淋巴瘤，伴有血清IgM和IgA升高的两个单克隆峰值。
