title: [Idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia and pleural effusion].
abstract: A 56-year-old man was admitted for further evaluation of mediastinal lymphadenopathy and left pleural effusion. A blood test revealed polyclonal hypergammaglobulinemia with an elevated erythrocyte sedimentation rate and level of C-reactive protein. Chest computed tomography disclosed bilateral hilar and multiple mediastinal lymph-node swelling and bilateral pleural thickening accompanied by a moderate amount of left pleural effusion. Biopsy specimens from mediastinal lymph nodes and the right pleura were obtained under video-assisted thoracoscopy. Histology on microscopic examination demonstrated mature plasma cells and lymphocyte infiltration in the conserved lymph-node structure and the pleura, suggesting a diagnosis of idiopathic plasmacytic lymphadenopathy (IPL) with polyclonal hyperimmunoglobulinemia. Interestingly, IL-6 was elevated in the pleural effusion but normal in serum. This was a rare and instructive case of IPL accompanied by pleural effusion that was considered to be an important determinant of the clinical spectrum of the disease.
authors.affiliation: Department of Respiratory Medicine, Juntendo University Medical School, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Mori
authors.forename: K
authors.initials: K
authors.lastname: Maeda
authors.forename: K
authors.initials: K
authors.lastname: Hasunuma
authors.forename: H
authors.initials: H
authors.lastname: Takahashi
authors.forename: T
authors.initials: T
authors.lastname: Dambara
authors.forename: K
authors.initials: K
authors.lastname: Tamayose
authors.forename: K
authors.initials: K
authors.lastname: Oshimi
authors.forename: H
authors.initials: H
authors.lastname: Miyamoto
authors.forename: S
authors.initials: S
authors.lastname: Tominaga
authors.forename: T
authors.initials: T
authors.lastname: Uekusa
authors.forename: Y
authors.initials: Y
authors.lastname: Fukuchi
mesh_terms: D015415:Biomarkers / Q000032:analysis; D006801:Humans; D006942:Hypergammaglobulinemia / Q000150:complications*; D008206:Lymphatic Diseases / Q000150:complications* / Q000473:pathology; D008297:Male; D008477:Mediastinal Diseases / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D010950:Plasma Cells / Q000473:pathology*; D010996:Pleural Effusion / Q000209:etiology*
chemical_list: D015415:Biomarkers