Multicentric giant lymph node hyperplasia with ascites and double cancers, an autopsy case

A 70-year-old man, diagnosed to have multicentric giant lymph node hyperplasia (MGLNH) of the plasma cell type by postmortem examination, had double cancers of the thyroid and kidney, as well as a large amount of ascites and persistent serositis. Serum immunoelectrophoresis showed monoclonal IgG (lambda). Using the paired immunofluorescent technique, monoclonal plasma cell proliferation was observed on the section of a lymph node. The cause of the ascites was speculated to be the combined influence of peritonitis, renal dysfunction and obstruction of abdominal lymphatic ducts. Occurrence of double cancers and persistent peritonitis suggest the long-standing faulty immune regulation in MGLNH.