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Triclonal gammopathy in an extranodal non-Hodgkin lymphoma patient
Angelo Tirelli1, Salvatore Guastafierro, Benedetto Cava
1Department of Hematology, Transfusion Medicine and Transplant Immunology, Second University of Naples, Naples, Italy.
The case of a patient with an extranodal non-Hodgkin lymphoma and three M-components (IgGkappa + IgGlambda + IgMlambda) in the serum is described. Three separate populations of M-component producing cells have been identified. Since a kappa-->lambda chain switch is not demonstrated, the synthesis of IgGkappa and IgGlambda by two distinct clones is obvious. IgMlambda and IgGlambda M-components are synthesized by two different plasma cell populations that could represent two unrelated cell clones or, alternatively, two subclones originated by a common precursor. After chemotherapy the IgGlambda M-component is replaced by heavy gamma chains without evidence of lambda light chains.
The case of a patient with an extranodal non-Hodgkin lymphoma and three M-components (IgGkappa + IgGlambda + IgMlambda) in the serum is described. Three separate populations of M-component producing cells have been identified. Since a kappa-->lambda chain switch is not demonstrated, the synthesis of IgGkappa and IgGlambda by two distinct clones is obvious. IgMlambda and IgGlambda M-components are synthesized by two different plasma cell populations that could represent two unrelated cell clones or, alternatively, two subclones originated by a common precursor. After chemotherapy the IgGlambda M-component is replaced by heavy gamma chains without evidence of lambda light chains.