IgG-κ型M蛋白血症を認めたMALTリンパ腫 MALT lymphoma producing IgG-κ type M-protein

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著者

    • 坂井 晃 SAKAI Akira
    • 広島大学原爆放射能医学研究所血液内科 Department of Hematology and Oncology, Division of Clinical Research, Research Institute for Radiation Biology and Medicine, Hiroshima University
    • 片山 雄太 KATAYAMA Yuta
    • 広島大学原爆放射能医学研究所血液内科 Department of Hematology and Oncology, Division of Clinical Research, Research Institute for Radiation Biology and Medicine, Hiroshima University
    • 水野 晶子 [他] MIZUNO Akiko
    • 広島大学原爆放射能医学研究所血液内科 Department of Hematology and Oncology, Division of Clinical Research, Research Institute for Radiation Biology and Medicine, Hiroshima University
    • 蔵本 憲 KURAMOTO Ken
    • 広島大学原爆放射能医学研究所血液内科 Department of Hematology and Oncology, Division of Clinical Research, Research Institute for Radiation Biology and Medicine, Hiroshima University
    • 瀧本 泰生 TAKIMOTO Yasuo
    • 広島大学原爆放射能医学研究所血液内科 Department of Hematology and Oncology, Division of Clinical Research, Research Institute for Radiation Biology and Medicine, Hiroshima University
    • 木村 昭郎 KIMURA Akiro
    • 広島大学原爆放射能医学研究所血液内科 Department of Hematology and Oncology, Division of Clinical Research, Research Institute for Radiation Biology and Medicine, Hiroshima University

抄録

症例は72歳,女性。特発性血小板減少性紫斑病と自己免疫性肝炎に対し約3年間プレドニンおよびイムランを投与し軽快したが,血清中にIgG-κ型のM蛋白を認めた。骨髄中には形質細胞の増加はなく,小腸と大腸に腫瘤を認めた。病理組織学的にIgGおよびκ陽性のMALTリンパ腫と診断し,THP-COP療法を施行したところ腫瘍の縮小とともに血清中IgG値も正常化した。以上より血清中のIgG-κ型M蛋白はMALTリンパ腫由来と考えられ,その原因に免疫抑制剤の投与も疑われた。

A 72-year-old woman, who has been administered predonisolone and azathioprine with diagnoses of idiopathic thrombocytopenic purpura (ITP) and autoimmune hepatitis (AIH), underwent a complete medical examination because of monoclonal gammopathy (IgG-κ). Tumors were found in the ileum and descending colon. Pathological examination of biopsy specimens suggested a diagnosis of marginal zone B-cell lymphoma of the MALT type with a high-grade component. Flow cytometric analysis by two-color staining revealed that the neoplastic B cells expressed CD38, CD19, IgG and κ, but not CD5 or CD10. There were no abnormal plasma cells in bone marrow smears. The patient achieved complete remission after receiving three cycles of THP-COP chemotherapy, which resulted in a decrease of the IgG level to within the normal range. These findings indicated that monoclonal IgG-κ might be produced by lymphoma cells. However, the relationship of the immunosuppressive agents to the pathogenesis of the MALT lymphoma remains to be clarified.

収録刊行物

  • 臨床血液

    臨床血液 41(8), 658-663, 2000-08-30

    The Japanese Society of Hematology

参考文献:  12件中 1-12件 を表示

被引用文献:  2件中 1-2件 を表示

各種コード

  • NII論文ID(NAID)
    10008038090
  • NII書誌ID(NCID)
    AN00252940
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    04851439
  • NDL 記事登録ID
    6295765
  • NDL 雑誌分類
    ZS21(科学技術--医学--内科学)
  • NDL 請求記号
    Z19-295
  • データ提供元
    CJP書誌  CJP引用  NDL  J-STAGE 
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