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KMID : 0882419960500030427
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Korean Journal of Medicine
1996 Volume.50 No. 3 p.427 ~ p.434
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Chronic Lymphocytic Leukemia with Monoclonal Gammopathy(IgM, 감마 Type)
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김탁관
이종목/윤형진/이승석/이상구/이정호/이동철/이영현/양창헌
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Abstract
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It appears that chronic lymphocytic leukemia (CLL) has a world wide distribution, but the incidence of CLL has known to be low in Korea. Hypogammaglobulinemia is common in chronic lymphocytic leukemia, but monoclonal gammopathy is rare. So we
present a
case of B-cell chronic lymphocytic leukemia associated with monoclonal gammopathy (IgM, λtype). A 60-year-old male patient visited Dongguk University Hospital due to blood-tinged sputum, cough and dyspnea for 3 to 4 weeks. Physical examination
revealed
inspiratory rales on the right lower lung field. Non-tender 5 linger breaths sized splenomegaly and both inguinal lymphadenopathy. Radiologic study showed a single lung abscess accompanied by acute bacterial pneumonia on the right lower lobe. The
peripheral blood smear and bone marrow examination presented many mature appearing small sized lymphocytes. The bone marrow biopsy revealed nodular lymphocyte infiltrates. On the immunohistochemical stain, These cells exhibited anti-CD19
phenotype.
The
lymph node was largely flooded by small monotonous mature lymphocytes. Serum protein electrophoresis and immunoelectrophoresis showed monoclonal gammopathy(IgM. λ type. 3.7g/Dl). The immunophenotyping study of lymphocytes demonstrated CD19 (+),
CD20
(+), HLA-DR (+) but CD5(-), We concluded that this patient's diagnosis is B-cell chronic lymphocytic leukemia with monoclonal gammopathy.λ
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KEYWORD
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