AI Article Synopsis
- A 74-year-old woman, previously treated for lymphoma, was hospitalized for low back pain, leading to the discovery of monoclonal IgG protein and myeloma cells in her bone marrow.
- Biochemical tests indicated high protein levels, and the presence of both kappa and lambda light chains suggested complex plasma cell activity.
- Despite treatment with melphalan and prednisone, her condition did not improve significantly, and she later developed angioimmunoblastic T-cell lymphoma, highlighting the rarity of biclonal gammopathy in multiple myeloma cases.
Article Abstract
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.
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| http://dx.doi.org/10.2177/jsci.25.170 | DOI Listing |
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