Abstract
This report describes a 57 year-old female case of lymphoid interstitial pneumonia (LIP) associated with polyclonal gammopathy and generalized lymphadenopathy. Her primary complaints were cough, exertion dyspnea and loss of weight. Chest X-ray film showed bilateral diffuse patchy and nodular shadow and decreased lung volume. Transbronchial lung biopsy revealed marked infiltration of mature plasma cells and lymphocytes into the interstitium. Remarkable plasma cell proliferation was noticed in swollen lymph nodes histologically, but follicular structures were not destroyed.
In vitro IgG and IgM synthesis by peripheral blood lymphocytes were assessed by means of mixed culture of T and B lymphocytes. Patient B cells were suggested to be polyclonally activated. The polyclonal B cell activation might be the consequence of the augmented helper function of patient T cells. We believe LIP in the present case is a pulmonary manifestation of systemic lymphoplasmacytic proliferative disorder.
