[Biclonal light chain gammopathy in multiple myeloma--a case report].
A 74-year-old woman was admitted to our hospital in March 1998 for low-back pain. In 1990, she had a chemotherapy for diffuse mixed cell lymphoma. Biochemical and serologic assays revealed a total protein level of 9.7 g/dl and an IgG level of 4,530 mg/dl. Immunoelectrophoresis showed monoclonal IgG protein associated with two monoclonal kappa and lambda light chain components. Bone marrow examination showed proliferation of myeloma cells comprising up to 25% of all nucleated cells. Myeloma cells were immunohistochemically positive for IgG and kappa and lambda light chains. IgG contained equal amounts of IgG 1 and IgG 2 subtypes and the complementarity determining region 3 (CDR 3) of myeloma cells showed oligoclonality by polymerase chain reaction, suggesting the myeloma cells may have two components. The patient received melphalan and prednisone in combination, resulting in only a minor response. She eventually developed angioimmunoblastic T-cell lymphoma. Biclonal gammopathy associated with malignant lymphoma is rare in case of multiple myeloma and may provide some insight into the pathogenesis of plasma cell tumors.
Ogasawara
Toshie
T
Department of Medicine, Tokyo Women's Medical University Daini Hospital.
Yasuyama
Masako
M
Kawauchi
Kiyotaka
K
D000368:Aged; D005260:Female; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000032:analysis*; D007145:Immunoglobulin kappa-Chains / Q000032:analysis; D007146:Immunoglobulin lambda-Chains / Q000032:analysis; D016399:Lymphoma, T-Cell / Q000150:complications / Q000276:immunology; D009101:Multiple Myeloma / Q000150:complications / Q000276:immunology*; D010265:Paraproteinemias / Q000150:complications*
D007147:Immunoglobulin Light Chains; D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains