Abstract
A 57-year-old male first sought medical assistance for general malaise and weight loss. Physical examination revealed generalized lymphadenopathy. Peripheral blood examination revealed only mild anemia and leucocytosis with a normal differential. Serum protein study revealed monoclonal gammopathy with IgM-κ type, although myelogram showed no lymphoplasmacytic proliferation. Furthermore both cryo-and pyroglobulin were found in the serum, and they were shown to consist mainly of M protein. The excised lymph nodes revealed histological characteristics of angio-immunoblastic lymphadenopathy. Peripheral lymphocyte examination showed the slight decrease of B cell and Tγ cell population.
Polyclonal hyperglobulinemia frequently accompanies angioimmunoblastic lymphadenopathy. However it seems rare that macroglobulinemia appears with the histology of angio-immunoblastic lymphadenopathy. This case could be an example of monoclonal immunoblastosis.
