Abstract
Background:
Lymphoplasmacytic lymphoma (LPL) is a low grade lymphoma. Most cases are Waldenstorm macroglobulinemia which has IgM hypergammaglobulinemia. Lymphoplasmacytic lymphoma with IgA hypergammaglobulinemia is less than 5%. Liver involvement was reported in 20%. However this disease has been found to be mostly presented with lymphadenopathy and hypergammaglobulinemia.
Case report:
We present a forty-year-old woman with anemia, renal insufficiency and abnormal liver function test. Liver biopsy showed atypical clonal B-cell lymphoproliferation, small cells with prominent plasmacytic differentiation. Serum protein electrophoresis showed monoclonal gammopathy which was IgA. Rituximab, fludarabine and cyclophosphamide were given and resulting in partial response.
Conclusion:
The presentation of LPL can mimic multiple myeloma (anemia, renal failure and monoclonal gammopathy). Definite histological and immunological technique should be done to confirm the diagnosis.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Antibodies, Monoclonal / therapeutic use
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Agents / therapeutic use
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Antirheumatic Agents / therapeutic use
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Cyclophosphamide / therapeutic use
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Female
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Humans
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Hypergammaglobulinemia / diagnosis
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Hypergammaglobulinemia / drug therapy
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Hypergammaglobulinemia / immunology
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Hypergammaglobulinemia / physiopathology*
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Immunoglobulin A*
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Immunologic Factors / therapeutic use
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Liver Diseases / diagnosis
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Liver Diseases / immunology
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Liver Diseases / physiopathology*
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Rituximab
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Thailand
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Vidarabine / analogs & derivatives
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Vidarabine / therapeutic use
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Waldenstrom Macroglobulinemia / diagnosis
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Waldenstrom Macroglobulinemia / drug therapy
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Waldenstrom Macroglobulinemia / immunology
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Waldenstrom Macroglobulinemia / physiopathology*
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Agents
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Antirheumatic Agents
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Immunoglobulin A
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Immunologic Factors
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Rituximab
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Cyclophosphamide
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Vidarabine
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fludarabine