[Pulmonary Waldenström's macroglobulinemia--a case report].
A case of Waldenström's macroglobulinemia (WMG) with principally pulmonary manifestation is presented. A 47-year-old man was admitted to our hospital with complaints of shortness of breath and an increasingly enlarged right pulmonary nodule, which had first been discovered about 2 years prior to admission. The liver, spleen and lymph nodes were not enlarged. Hematological examination revealed Hb 12.8 g/dl, platelet 28.2 x 10(4)/microliters and WBC 7,400/microliters without pathological cells. A bone marrow aspirate showed no remarkable abnormalities. A quantitative measurement of serum immunoglobulin gave values for IgG of 2,264 mg/dl, IgA of 393 mg/dl and IgM of 1,332 mg/dl, and M-protein of IgM, K type was observed on serum immunoelectrophoresis. Chest X-ray film showed a 5 x 4 cm poorly defined mass in the right middle lobe. Histological examination of a mass obtained by an open lung biopsy revealed diffuse proliferation of lymphoplasmacytoid cells. Monoclonal IgM, K was demonstrated in the cytoplasma of these cells by the PAP method. These data established the diagnosis of pulmonary WMG. He received VEPA therapy, and pulmonary mass lesion gradually decreased and his serum IgM level had decreased to 465 mg/dl 2 months after the initiation the chemotherapy.
Masu
M
M
Ishikawa
T
T
Yabe
H
H
Nagai
K
K
Nakayama
S
S
D006801:Humans; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008258:Waldenstrom Macroglobulinemia / Q000473:pathology*