A case of nodal marginal zone B-cell lymphoma with macroglobulinemia / 대한내과학회지

ABSTRACT

Macroglobulinemia is the result of an uncontrolled proliferation of lymphocytes and plasma cells in which a large IgM M protein is produced. IgM monoclonal gammopathy is recognized in a variety of lymphoproliferative diseases and Waldenstr?m's macroglobulinemia (WM) is the most frequent disease in this group. We report a case of nodal marginal zone B-cell lymphoma (Nodal MZBCL) accompanied by monoclonal macroglobulinemia. A 58-year-old man was admitted to the hospital with chronic fatigue and dyspnea. Physical examination revealed cervical, subaxillary, and inguinal lymphadenopathy. Histopathologically, monocytoid B cells with abundant pale cytoplasm and small nuclei infiltrated the cervical lymph node. The neoplastic cells were positive for CD 20, bcl-2, and IgM. The serum and urine electrophoresis showed monoclonal spike in the globulin region and immunoelectrophoresis demonstrated immunoglobulin of IgM, kappa type. Immunohistochemically, this monoclonal gammaglobulinemia (IgM, Kappa) was produced and secreted from the nodal MZBCL. This is the first report of nodal MZBCL accompanying macroglobulinemia in Korea.