Lymphocytic interstitial pneumonia associated with a marked increase in monoclonal IgM-kappa-type rheumatoid factor and serum CA19-9.
A 62-year-old Japanese female was admitted due to dyspnea. She showed a marked increase in CA19-9 (maximum, 192,000 U/ml) and monoclonal IgM-kappa type rheumatoid factor (RF) activity. The patient died of respiratory failure 3 months later. Autopsy findings revealed an infiltration of IgM-kappa-positive plasma cells in the pulmonary interstitium, and therefore a diagnosis of lymphoid interstitial pneumonia (LIP) was made. The bronchoepithelial cells were stained with monoclonal antibody-reactive with CA 19-9 antigen. This is the first documented LIP, associated with a marked increase in monoclonal IgM-kappa type RF and CA19-9 in the serum.
Takata
T
T
First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Nagafuchi
S
S
Tsuda
H
H
Uehira
K
K
Kondo
S
S
Ueda
A
A
Ishii
H
H
Niho
Y
Y
D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis* / Q000097:blood; D001402:B-Lymphocytes / Q000473:pathology*; D005260:Female; D006801:Humans; D006942:Hypergammaglobulinemia / Q000150:complications*; D007075:Immunoglobulin M / Q000032:analysis*; D007145:Immunoglobulin kappa-Chains / Q000032:analysis*; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000150:complications*; D010950:Plasma Cells / Q000473:pathology*; D011658:Pulmonary Fibrosis / Q000209:etiology* / Q000473:pathology; D012131:Respiratory Insufficiency / Q000209:etiology; D012217:Rheumatoid Factor / Q000032:analysis*
D015295:Antigens, Tumor-Associated, Carbohydrate; D007075:Immunoglobulin M; D007145:Immunoglobulin kappa-Chains; D012217:Rheumatoid Factor