抄録
A 60-year-old man was admitted to Akita City Hospital because of unconsciousness on April 23, 1980. He had been treated as pneumonia and diabetes mellitus.
Physical examination disclosed rhonchi in the right lower lung, decreased deep tendon reflexes, and semicoma without pathological reflexes. Laboratory examination revealed; ESR, 38 mm/h, BJP (λ) in urine, positive, serum IgG concentration, 1,169 mg/dl, IgA 2,508 mg/dl, IgM 99 mg/dl. Serum electrophoresis showed two abnormal peaks in α2∼β and γ-region, and two M-components (IgA-κ, IgA-λ) were observed by immunoelectrophoreris. M. W of IgA-κ seemed to be larger than that of IgA-λ by immuno gel filtration study. Bone marrow aspiration study showed 140,000 nucleated cells/cmm with 10% plasma cells containing flaming and mitotic cells. On the 33rd Hospital day he died without improvements of conciousness.
Autopsy findings were as follows; 1) tracheal cancer in the bifurcation (undifferentiated type), metastasizing to lymphonodes, lungs, thoracic and lumbar vertebrae. 2) hemorrhagic duodenal ulcer. 3) slightly diabetic changes. Histological study disclosed a pronounced plasma cell infiltration surrounding the mass of the neoplasm. Immunoenzymologic method revealed that plasma cells surrounding the tumor contained IgA-κ dominantly, but in the bone marrow without metastasis they had IgA-λ dominantly.
