ABSTRACT
Waldenstr's macroglobulinemia is a slowly progressing disease characterized by proliferation of small lymphocytes, plasmacytoid lymphocytes and plasma cells in the bone marrow with increased serum monoclonal IgM. Since 1944, only a few cases of Waldenstr's macroglobulinemia with pulmonary involvement have been described. We experienced a case of Waldenstr's macroglobulinemia with pulmonary involvement. The patient was 66-year-old male complaining dyspnea. His cytological finding of pleural fluid aspirates revealed many plasmacytoid lymphocytes. Serum electrophoresis showed the sharp M-peak in the gamma globulin region, which was identified as a IgM, kappa type by immunofixation. Bone marrow findings showed small lymphocytic and plasmacytoid lymphocytic infiltration.
Subject(s)
Aged , Humans , Male , Bone Marrow , Dyspnea , Electrophoresis , gamma-Globulins , Immunoglobulin M , Lymphocytes , Plasma Cells , Waldenstrom MacroglobulinemiaABSTRACT
BACKGROUND: Cellular fibronectin (cFN) is derived from the cell surface and extracellular matrix. It is fragmented by proteolytic enzymes, which is released from invasive and malignant tumor cells. It is circulated in blood and body fluids, and finally excreted in urine. This study was undertaken to determine the usefulness of plasma and urine cFN as a tumor marker of gastrointestinal tract cancers. METHODS: We measured the concentration of cFN in plasma and urine samples by Fibronectin EIA kit (Takara Shuzo Co., Ltd., Shiga, Japan). Subjects were 20 healthy adults, 20 patients with benign diseases, 51 patients with stomach cancer and 22 patients with colorectal cancer. We evaluated the clinical records to compare the concentrations of cFN with stage and degree of cancer metastasis. RESULTS: At the recommend cut-off values of 21 microgram/mL in plasma and 157 ng/mgCr in urine, the sensitivity of plasma and urine cFN was 41.2% and 43.1% in gastric cancers; 40.9% and 50.0% in colorectal cancers, respectively. The specificity of urine cFN was 92.5% as compared to 67.1% for plasma cFN. The cFNs in plasma and urine were significantly elevated in cancer group and the concentrations were increased further with peritoneal seeding and distant metastasis. The sensitivity of urine cFN was 73.3% in stomach cancers and 100% in colorectal cancers with distant metastasis. CONCLUSION: The urine cFN is specific and the concentrations increase further with metastasis, and may be useful in diagnosis and monitoring of gastrointestinal tract cancers. Further detailed studies must be made in a large number of patients.
Subject(s)
Adult , Humans , Body Fluids , Colorectal Neoplasms , Diagnosis , Extracellular Matrix , Fibronectins , Gastrointestinal Neoplasms , Gastrointestinal Tract , Neoplasm Metastasis , Peptide Hydrolases , Plasma , Sensitivity and Specificity , Stomach NeoplasmsABSTRACT
Plasma col1 leukemia with motility-related morphological behavior is rarely studied. The plasma cells have variable degrees of cytoplasmic morphologies as dairy Projections, long extensions and pseudopods. These morphological evidences show the papa bility of wide spread and dissemination of disease itself. We present a case of a 38 year old woman who had back pain for 4 months and was diagnosed as a solitary plasmacytoma of the third lumbar vertebra. In spite of resection of the tumor and chemotherapy, the plasmacytoma was disseminated into both breasts and ovaries within less than a year. On her blood examination, we counted 34% of plasma cells in peripheral blood and 91.6% of plasma cells in bone marrow aspiration. Most of them resealed hairy projections and pseudopods of the cytoplasm.