Lymphoplasmacytic lymphoma. Report of a case with three monoclonal proteins derived from a single neoplastic clone

Abstract

The unique case of a 60-year-old patient with a non-Hodgkin's B-cell lymphoma of the lymphoplasmacytic type and three associated monoclonal proteins, is described. The patient also exhibited various autoimmune phenomena that were consistent with the diagnoses of Sjögren's syndrome and autoimmune thyroiditis. The evolution from production of a single monoclonal protein (IgM-kappa) to three monoclonal proteins (IgG-kappa, IgA-kappa, and IgM-kappa) suggested that the lymphoplasmacytic cells were at different stages of terminal differentiation within a single neoplastic clone. The chronic antigenic stress imposed on the immune system by the autoimmune disorder may have played a role in the development of lymphoma and in the heavy chain immunoglobulin switching that occurred during the patients' clinical course.

Primary cutaneous marginal zone lymphoma with subclinical cutaneous involvement and biclonality

“…Ongoing somatic hypermutation is a feature of MALT lymphoma and at least heavy chain isotype switching has been shown in cutaneous B-cell lymphoma and lymphoplasmacytic lymphoma. 34,35 In conclusion, our report illustrates the existence of a peculiar form of PCMZL exhibiting at least two different clones that initially presented with papules and later involved clinically normal and minimally erythematous skin. Therefore, in a patient with PCZML, biopsies of evanescent erythematous patches and even normal skin should be considered during staging and clinical follow-up.…”

“…It is also possible that even though two different light chains were expressed in our patient's tissue, the two populations were clonally related to each other. Ongoing somatic hypermutation is a feature of MALT lymphoma and at least heavy chain isotype switching has been shown in cutaneous B‐cell lymphoma and lymphoplasmacytic lymphoma 34,35 …”

Five monoclonal proteins in a patient with chronic myelomonocytic leukemia

“…He was treated with behenoyl cytosine arabinoside, daunorubicin, 6-niercaptopurine, and prednisolone. A complete remission was achieved after I month, The patient remains in complete remission in June 1991.DM is a rare and severe disorder characterized by an inflammatory myopathy and typical cutaneous lesions [3]. Some reports have noted that patients with DM develop malignant neoplastic disease, and that the most common tumors associated with DM are those of the lungs.…”

“…DM is a rare and severe disorder characterized by an inflammatory myopathy and typical cutaneous lesions [3]. Some reports have noted that patients with DM develop malignant neoplastic disease, and that the most common tumors associated with DM are those of the lungs.…”