[Idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia and pleural effusion].
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.
Mori
T
T
Department of Respiratory Medicine, Juntendo University Medical School, Tokyo, Japan.
Maeda
K
K
Hasunuma
K
K
Takahashi
H
H
Dambara
T
T
Tamayose
K
K
Oshimi
K
K
Miyamoto
H
H
Tominaga
S
S
Uekusa
T
T
Fukuchi
Y
Y
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*
D015415:Biomarkers