Abstract
A case of reticulosis with persistent macroglobulinemia and transient macro-pyroglobulinemia during the course is presented.
The patient, 68 year-old female, was admitted to the Chukyo Hospital because of nasal bleeding in November, 1972. She noticed a subcutaneous induration without pain in the right thigh in 1970. Tumor-like indurations with size of up to hen's egg appeared on the chest, trunk and thigh, and bleeding tendency such as purpura and gum bleeding developed in September, 1972. She responded to steroid therapy with decrease of the size of tumors and bleeding manifestations.
Biopsy of tumors having character of lymphatic tissue disclosed proliferation of reticulum cells, moderate depletion of lymphocytes and slight increase of plasma cells and macrophages. Although cell infiltration into outside the capsule and destruction of nodal architecture were noted, cataplastic reticulosis was diagnosed histologically because of the presence of variety of lymphoreticular cells.
Serum analysis revealed the polyclonal increase of IgG and A, and monoclonal elevation of IgM which exhibited the nature of pyroglobulin transiently during the course of the diseaee.
In view af the lymphoreticular proliferation and persistent presence of monoclonal IgM, the reticulosis with macroglobulinemia was considered as pertinent to the patient's state, though she should be carefully followed up for the transformation to the typical Waldenströn's macroglobulinemia.
