title: [Follicular lymphoma complicated with myelofibrosis and macroglobulinemia at initial presentation].
abstract: A 49-year-old woman presented with pharyngeal and cervical lymph node swelling in December 2010. Biopsy of the pharynx demonstrated follicular lymphoma which secreted large volumes of immunoglobulin M (IgM) and transforming growth factor-β (TGF-β). Bone marrow aspiration yielded a dry tap, and bone marrow biopsy demonstrated myelofibrosis associated with lymphoma cells on admission. The plasma concentration of TGF-β was elevated and monoclonal IgM gammopathy was detected. After only one course of chemotherapy with CHOP plus rituximab, remission of both lymphoma and myelofibrosis was achieved. Bone marrow aspiration became possible, and TGF-β and IgM levels normalized. Thus, the myelofibrosis was reversible.
authors.affiliation: Department of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuroda
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Abe
authors.forename: Wataru
authors.initials: W
authors.lastname: Jomen
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Teppei
authors.initials: T
authors.lastname: Matsuno
authors.forename: Masanori
authors.initials: M
authors.lastname: Sato
authors.forename: Michiko
authors.initials: M
authors.lastname: Yamada
authors.forename: Tamaki
authors.initials: T
authors.lastname: Sakurai
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Fujii
authors.forename: Masahiro
authors.initials: M
authors.lastname: Maeda
authors.forename: Miri
authors.initials: M
authors.lastname: Fujita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Nagashima
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Murase
authors.forename: Junji
authors.initials: J
authors.lastname: Kato
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008224:Lymphoma, Follicular / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D055728:Primary Myelofibrosis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D008258:Waldenstrom Macroglobulinemia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007075:Immunoglobulin M; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone