IgM-κ 및 IgA-λ 이중클론감마병증을 가진 림프형질세포림프종/발덴스트롬마크로글로불린혈증 1례
A Case of Lymphoplasmacytic Lymphoma/Waldenström’s Macroglobulinemia with IgM-κ and IgA-λ Biclonal Gammopathy
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초록
림프형질세포림프종은 소림프구, 형질세포양림프구, 형질세포로 이루어진 저등급 B-세포림프종으로서 골수, 림프절, 비장을 침범하는 질환이다. 림프형질세포림프종은 대개 골수를 침범하는데 IgM 단클론감마병증이 동반되는 경우 발덴스트롬마크로글로불린혈증이라고 일컫는다. IgM이 아닌 단클론감마병증 또는 이중클론감마병증을 동반하는 림프형질세포림프종은 매우 드물다. 통상적으로 골수 및 유세포검사를 통해 그 형태학적 소견과 세포의 면역표현형으로 진단을 하였는데, 최근에는 myeloid differentiation factor 88 (MYD88) 유전자의 L265P 돌연변이 검사가 림프형질세포림프종을 진단하는 데 많은 도움이 되고 있다. 저자들은 아직 국내에서 보고되지 않은 IgM-κ/IgA-λ 이중클론감마병증을 동반한 림프형질세포림프종 1예를 경험하였기에 문헌고찰과 함께 보고하고자 한다.
Abstract
Lymphoplasmacytic lymphoma (LPL) is a low-grade B-cell neoplasm, composed of small B lymphocytes, plasmacytoid lymphocytes, and plasma cells, usually involving bone marrow and sometimes lymph nodes or spleen. LPL with bone marrow involvement and an IgM monoclonal gammopathy of any concentration is designated as Waldenström macroglobulinemia (WM). LPL associated with non-IgM monoclonal gammopathy or biclonal gammopathy is rarely observed. LPL diagnosis was based on clinical, morphological, and immunophenotypic findings. Recently, the test for L265P mutation of the myeloid differentiation factor 88 (MYD88) gene has been helpful in the diagnosis of LPL. Here, we reported the first case of LPL/WM with IgM-κ/IgA-λ biclonal gammopathy in Korea.
참고문헌 (24)
- The Korean Society of Hematology, "Hematology", pp.367~ (2018), Panmun Education
- Swerdlow SH, "WHO classication of tumours of haematopoietic and lymphoid tissues", pp.236~ (2017), IARC
- 강지훈, "Clinical features and survival outcomes of patients with lymphoplasmacytic lymphoma, including non-IgM type, in Korea: a single-center experience", Blood Research, 53(3), pp.189~197 (2018), 대한혈액학회
- King RL, "Lymphoplasmacytic lymphoma with a non-IgM paraprotein shows clinical and pathologic heterogeneity and may harbor MYD88 L265P mutations", Am J Clin Pathol, 145, pp.843~851 (2016)
- Cao X, "Clinicopathologic features and outcomes of lymphoplasmacytic lymphoma patients with monoclonal IgG or IgA paraprotein expression", Leuk Lymphoma, 57, pp.1104~1113 (2016)
- 신상용, "Detection of MYD88 L265P in patients with lymphoplasmacytic lymphoma", Waldenstrom macroglobulinemia and other B-cell non-Hodgkin lymphomas, 2016, pp.51(3), 181~186[DOI]
- Wadhwa J, "Lymphoplasmacytic lymphoma", JIPMER Journal of Cancer, 4, pp.52~54 (2014)
- García-García P, "Biclonal gammopathies : retrospective study of 47 patients", Rev Clin Esp, 215, pp.18~24 (2015)
- Naderi N, "Lymphoplasmacytic lymphoma and Waldenström macroglobulinemia", Arch Pathol Lab Med, 137, pp.580~585 (2013)
- Kumar SK, "Multiple myeloma, version 3.2017, NCCN clinical practice guidelines in oncology", J Natl Compr Canc Netw, 15, pp.230~269 (2017)
- Kapoor P, "Diagnosis and management of Waldenström macroglobulinemia : Mayo Stratification of Macroglobulinemia and Risk-Adapted Therapy(mSMART)Guidelines 2016", JAMA Oncol, 3, pp.1257~1265 (2017)
- Schuster SR, "IgM multiple myeloma : disease denition, prognosis, and differentiation from Waldenstrom’s macroglobulinemia", Am J Hematol, 85, pp.853~855 (2010)
- Wang E, "Concomitant Waldenstrom macroglobulinemia and IgA plasmablastic myeloma in a patient with untreated IgM paraproteinemia : sequential development of biclonal B-cell neoplasms over a 10-year period in a single individual", Hum Pathol, 43, pp.1135~1141 (2012)
- Rossi D, "Role of MYD88 in lymphoplasmacytic lymphoma diagnosis and pathogenesis", Hematology Am Soc remato Educ Program, 2014, pp.113~118 (2014)
- Kyle RA, "Long-term follow-up of monoclonal gammopathy of undetermined signicance", N Engl J Med, 378, pp.241~249 (2018)
- McMaster ML, "Novel aspects pertaining to the relationship of Waldenström’s macroglobulinemia, IgM monoclonal gammopathy of undetermined signicance, polyclonal gammopathy, and hypoglobulinemia", Clin Lymphoma Myeloma, 9, pp.19~22 (2009)
- Murphy K, "Janeway’s Immunobiology", pp.167~ (2009), Garland Science, Taylor & Francis Group, LLC
- Treon SP, "MYD88 L265P somatic mutation in Waldenström’s macroglobulinemia", N Engl J Med, 367, pp.826~833 (2012)
- Willenbacher W, "Improved accuracy of discrimination between IgM multiple myeloma and Waldenström macroglobulinemia by testing for MYD88 L265P mutations", Brit J Haematol, 161, pp.902~904 (2013)
- Xu L, "MYD88 L265P in Waldenström macroglobulinemia, immunoglobulin M monoclonal gammopathy, and other B-cell lymphoproliferative disorders using conventional and quantitative allele-specic polymerase chain reaction", Blood, 121, pp.2051~2058 (2013)
- Jiménez C, "MYD88 L265P is a marker highly characteristic of, but not restricted to, Waldenström’s macroglobulinemia", Leukemia, 27, pp.1722~1728 (2013)
- Ondrejka SL, "MYD88 L265P somatic mutation : its usefulness in the differential diagnosis of bone marrow involvement by B-cell lymphoproliferative disorders", Am J Clin Pathol, 140, pp.387~394 (2013)
- Shendure J, "Next-generation DNA sequencing", Nat Biotechnol, 26, pp.1135~1145 (2008)
- Schuster SC, "Next-generation sequencing transforms today’s biology", Nat Methods, 5, pp.16~18 (2008)
