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Plasmacytoid lymphocytic lymphoma presenting with IgG hyperviscosity syndrome and peritoneal lymphomatosis

Y J Lan1, P Dunn, L Y Shih

  • 1Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.

Changgeng Yi Xue Za Zhi
|June 1, 1995
PubMed

Insights

This case study highlights a rare presentation of plasmacytoid lymphocytic lymphoma with IgG hyperviscosity syndrome and peritoneal involvement. Despite initial improvement with plasmapheresis, the patient succumbed to sepsis.

Area of Science:

  • Hematology
  • Oncology
  • Immunology

Background:

  • Plasmacytoid lymphocytic lymphoma is a rare B-cell malignancy.
  • Hyperviscosity syndrome can complicate lymphoproliferative disorders.
  • Peritoneal involvement in lymphoma can mimic other conditions.

Observation:

  • A 74-year-old woman presented with dyspnea, altered consciousness, ascites, and skull lesions.
  • Laboratory findings revealed monoclonal IgG-lambda gammopathy and suppressed immunoglobulins.
  • Abdominal CT suggested cancerous peritonitis.

Findings:

  • The patient exhibited IgG hyperviscosity syndrome and diffuse peritoneal disease as initial manifestations of plasmacytoid lymphocytic lymphoma.
  • Lytic bone lesions and a high M-component with suppressed normal immunoglobulins were noted, atypical for lymphoma compared to multiple myeloma.

Implications:

  • This case underscores the importance of considering lymphoma in patients with unexplained hyperviscosity and peritoneal findings.
  • The co-occurrence of lytic bone lesions and suppressed immunity warrants careful differential diagnosis between lymphoma and multiple myeloma.
  • Early recognition and management of hyperviscosity syndrome are crucial for patient outcomes.

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