1987 Volume 28 Issue 4 Pages 594-600
A 22-year-old man was admitted because of low grade fever and general fatigue. Anemia, elevated ESR and polyclonal hyperimmunoglobulinemia were observed. There were hepatosplenomegaly and a 6×4cm mass on the left of umbilicus. A 67Ga scan showed abnormal uptake on the left side between third lumber vertebra and fourth one. Exploratory laparotomy was performed and several masses, each of which were nut or knuckle in size, were found in the mesentery beside Treitz's ligament. One of them was resected. Pathologically, the mass was a lymphnode composed of follicular hyperplasia and prominent sheets of mature plasma cell ploliferation in interfollicular areas. The presence of polyclonal immunoglobulins in the cytoplasma of plasma cells in the resected lymphnode were demonstrated by the peroxidase-antiperoxidase method. He was treated with 60Co and received 4,000 rads to a restricted port involving residual masses. Then clinical symptoms and labolatory data were improved gradually. Residual masses were resected by reoperation because of no remarkable decrease in size of them. Pathologically. there is no remarkable change between before and after radiation therapy. Radiation therapy may control the activity of proliferative cells, so in cases where complete removal of the lesion is impossible, radiation therapy is worth a trial.
