Diffuse large B-cell lymphoma expressing cytoplasmic IgM and κ in a patient with λ-type primary macroglobulinemia

Abstract

A 69-year-old woman who had had λ-type primary macroglobulinemia (PMG) since December 1993 was admitted in October 1997 because of obstructive jaundice due to compression of the common bile duct by a retroperitoneal tumor. A biopsy sample was obtained by exploratory laparotomy, and from this a diagnosis of diffuse large cell lymphoma (DLCL) expressing cytoplasmic IgM/κ was made. Partial remission was obtained after 6 courses of combination chemotherapy consisting of pirarubicin, cyclophosphamide, vincristine and prednisolone. However, the DLCL was generally progressive, and the patient died in August 1998 due to multiple organ failure. There was no difference in the plasma monoclonal IgM/λ level before and during the course of DLCL. The clone of the DLCL may have been different from that of the PMG.