Macroglobulinemia Waldenströmの一剖検例

抄録

An autopsy case of 62-year-old male with macroglobulinemia Waldenström was reported. The initial sign was swelling of the cervical lymph nodes, spreading gradually to the general lymph nodes. He was admitted to the hospital because of marked anemia and accelerated ESR. Serum electrophoresis showed an M-component, 36%, in γ region, which was demonstrated as IgM-K by immunoelectrophoresis. Ultracentrifugation showed a 15.8S fraction, 33.1%. In a biopsied lymph node, sarcomatous proliferation of various sized lymphocytes was observed and bone marrow puncture revealed marked hyperplasia of erythroblasts and moderate one of lymphoid cells. On autopsy, numerous plasma cells or plasmocytoid cells, occasionally with PAS positive intra-nuclear inclusions, were observed in sarcomatously swollen lymph nodes, and bone marrow was almost replaced by such plasmocytoid cells. Leukemic infiltration of these lymphoid or plasmocytoid cells was observed extensively in the liver, kidneys, spleen, lungs, brain and intestine. By observation with electron microscopy and fluorescent antibody technic on biopsied and autopsied materials, it was considered that those cells producing or containing abnormal macroglobulin were very close to the plasma cell series.