Non-Hodgkin lymphoma mimicking Polymyalgia rheumatica in a young patient

We present the case of a young patient who presented with symptoms suggestive of polymyalgia rheumatica [PMR] and was subsequently diagnosed to have stage IV non-Hodgkin's lymphoma [NHL]. The association of PMR with malignancies is discussed

[Sjogren's syndrome and lympho-proliferating syndrome-taking stock]

Sjogren's syndrome, the most frequent autoimmune connective tissue disorder, is associated with a risk of B lymphoid proliferation. The clinical risk factors are parotidomegaly, enlarged lymph nodes and splenomegaly. Fever, weight loss and a decline in the general health status as well as a rise in beta 2 micro globulin or the appearance of monoclonal immuno globulin in the plasma are the signs of malignant lymphoma complicating sjogren's syndrome. We discuss the therapeutic and physiopathologic implications of this ominous complication

Propuesta de caracterización y tipificación de proteínas monoclonales aplicable al laboratorio clínico / Proposal of characterization and typification of monoclonal proteins applicable to clinical laboratory

En el presente trabajo se incorporan y ordenan procedimientos para obtener la mayor información posible a nivel laboratorio clínico en la indagación de proteínas "M" y la definición de su clase (cadenas pesadas) y tipo (cadenas livianas). Se propone una secuencia de las siguientes técnicas: electroforesis, inmunoelectroforesis, inmunofijación, inmunodifusión radial cuantitativa, tratamientos despolimerizantes e inmunosustracción. La inmunosustracción, descripta por W. A. White y col., consiste en la remoción de la inmunoglobulina en estudio mediante un antisuero específico en presencia de polietilenglicol, separación del inmunocomplejo precipitado y posterior evaluación del sobrenadante mediante inmunofijación; se identifica la cadena liviana que pertenece a la inmunoblobulina sustraída por su ausencia al fijar con el antisuero correspondiente. Es particularmente útil cuando se desea establecer la correspondencia liviana/pesada en presencia de bandas homogéneas múltiples, identificar bandas menores enmascaradas en un fondo policlonal y excluir la presencia coincidente de cadenas livianas libres. Se aconseja incorporar el tratamiento despolimerizante con 2-mercaptoetanol previamente a la cuantificación de IgM por inmunodifusión radial ya que la comparación previa entre controles tratados y no tratados reveló una diferencia muy significativa cuando se analizó mediante contraste de diferencias entre pares homólogos (n = 12, test t = 37,2 p <0,01)

Immunoperoxidase study on paraffin sections of gastrointestinal lymphoreticular lesions.

Seventy-five cases of lymphoreticular lesions of the gastrointestinal tract were studied by the immunoperoxidase method on paraffin sections which demonstrated cytoplasmic markers, in particular immunoglobulin (Ig) in B-lymphocytes and alpha-1-antichymotrypsin in histiocytes. There were 4 cases of benign immunoproliferative disease (IPD), 1 in the stomach, 3 in the small intestine; their reactions were polyclonal. Large cell non-Hodgkin's lymphoma was subdivided into 21 cases with IPD ("Mediterranean Abdominal Lymphoma") and 29 cases without. Eight cases of lymphoma with IPD were gastric and 13 intestinal; 7 gastric and 12 intestinal lymphomas were of B-cell origin; 1 gastric tumour was histiocytic; 1 intestinal neoplasm had no detectable marker. Sixteen cases of lymphoma without IPD were gastric and 13 intestinal; 4 gastric and 4 intestinal lymphomas were of B-cell type; 3 gastric and 2 intestinal neoplasms were histiocytic; 1 intestinal tumour was a composite of B-cells and histiocytes, in separate but contiguous foci; 9 gastric and 4 intestinal lymphomas had no identifiable marker. One of 18 cases of mixed and small cell lymphoma was accompanied by IPD. In these types of lymphoma Ig was found only in 10-30% of cells, mainly with plasmacytoid differentiation.