Giant lymph node hyperplasia with osteoblastic bone lesions and the POEMS (Takatsuki's) syndrome.
A 38-year-old black man with giant lymph node hyperplasia (GLH), osteoblastic lesions, and the POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes) was treated at the University of Chicago Hospitals. The patient had hepatosplenomegaly and generalized peripheral lymphadenopathy. Endocrinologic abnormalities included decreased testosterone with elevated luteinizing hormone and follicle-stimulating hormone, as well as hyperprolactinemia and possible hypothyroidism. Biopsy of a right femoral lymph node revealed GLH, and an osteoblastic pelvic lesion showed a marked lymphoplasmacytic infiltrate. By immunohistochemical techniques, plasma cells in the lymph node and osteoblastic lesion were polyclonal. A polyclonal hypergammaglobulinemia was present. The lymph node T-lymphocyte population showed a decreased helper-to-suppressor cell ratio. Other findings included thickening of the skin, finger clubbing, and anasarca. A severe sensory-motor polyneuropathy was the major factor contributing to the patient's death. The association of GLH, osteoblastic bone lesions, and the POEMS syndrome has been noted previously in Japan; however, the authors are unaware of reports on Western patients who had this combination of clinical and laboratory findings.
D000328:Adult; D001344:Autopsy; D001706:Biopsy; D001847:Bone Diseases / Q000473:pathology*; D006651:Histocytochemistry; D006728:Hormones / Q000378:metabolism; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D007124:Immunoenzyme Techniques; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology*; D008206:Lymphatic Diseases / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D008297:Male; D010950:Plasma Cells / Q000276:immunology; D013577:Syndrome
D006728:Hormones