伴单克隆免疫球蛋白血症的淋巴瘤——附3例报告及文献复习

Lymphoma with monoclonal gammopathy: 3 cases report and review of literatures

目的:探讨伴单克隆免疫球蛋白血症的淋巴瘤患者的临床特征。方法:对3例伴单克隆免疫球蛋白血症的淋巴瘤患者的临床资料进行回顾性分析。结果:3例患者分别诊断为小淋巴细胞淋巴瘤(B细胞性)(B-SLL)、慢性淋巴细胞白血病(CLL)和脾边缘区淋巴瘤(SMZL),检查血清免疫球蛋白分别为单克隆IgG-kappa型、IgM-kappa型和Kappa型;临床表现均有贫血和肝脾肿大。结论:伴单克隆免疫球蛋白血症的淋巴瘤诊断需根据淋巴结和骨髓的病理学、血清免疫球蛋白、外周血或骨髓细胞免疫分型、融合基因综合判断;应注意与多发性骨髓瘤、原发性巨球蛋白血症的鉴别。

Objective： To explore the clinical features of lymphoma with monoclonal gammopathy. Methods： Clinical data of 3 cases with lymphoma associated with monoclonal gammopathy were analyzed retrospectively. Results： Three cases were diagnosed as B-cell small lymphocytic lymphoma（ B-SLL）,chronic lymphocytic leukemia（ CLL） and splenic marginal zone lymphoma（ SMZL） respectively,and their types of serum monoclonal immunoglobulin were IgG-kappa,IgM-kappa and Kappa respectively. All patients presented with anemia and hepatosplenomegaly. Conclusions： The diagnosis of lymphoma with monoclonal gammopathy should be based on pathology of lymphnode and bone marrow,serum immunoglobulin,peripheral blood or bone marrow immunophenotyping and fusion gene. It should be differentiated from multiple myeloma and Waldenstrom macroglobulinemia.