Gamma heavy chain disease in a patient with underlying lymphoplasmacytic lymphoma of the thyroid. Report of a case and comparison with other reported cases with thyroid involvement

Clinica Chimica Acta; International Journal of Clinical Chemistry
Josenia N M TanEvrim Erdogan

Abstract

Gamma heavy chain disease with underlying thyroid pathology is rare. There are 5 reported cases in the English literature, including the present case of an elderly female with γ heavy chain disease with underlying lymphoplasmacytic lymphoma of the thyroid who initially presented with long-standing goiter and chronic thyroiditis. The protein studies and histopathologic findings in her thyroid are described. Her case is compared with reported cases of γ heavy chain disease with thyroid involvement. Initial impression on most cases was chronic thyroiditis; however pathology showed 3 cases with plasmacytoma and 2 with lymphoplasmacytic infiltrate. All were diagnosed and followed up using serum and urine electrophoresis. Gamma heavy chain disease has a protean manifestation; however there appears to be a more uniform pattern of the disease when it is associated with the thyroid. The inclusion of protein studies in cases diagnosed with chronic thyroiditis by FNA may aid in establishing γ heavy chain disease with underlying thyroid involvement. In this case serum and urine electrophoresis, and immunofixation studies which are simple and affordable tests facilitated the hematologic workup and follow up.

References

Jan 1, 1979·Immunological Reviews·M SeligmannJ C Brouet
Jan 1, 1975·Journal of Clinical Pathology. Supplement (Association of Clinical Pathologists)·E C Franklin
Jun 1, 1985·Endocrinologia Japonica·S MatsubayashiS Nagataki
Oct 12, 2010·Annals of Clinical Biochemistry·L López-AngladaR García-Sanz

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Citations

Jul 26, 2017·Mediators of Inflammation·Eva Feigerlová, Shyue-Fang Battaglia-Hsu

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