Amyloid light-chain (AL) amyloidosis and follicular lymphoma: a case report

被引：0
作者：
Benmoussa, Amine [1 ]
Maatoui-Belabbes, Hajar [1 ]
Allali, Reda [2 ]
Regragui, Meriem [2 ]
Qachouh, Meriem [1 ]
Cherkaoui, Siham [1 ]
Lamchahab, Mouna [1 ]
Rachid, Mohamed [1 ]
Madani, Abdellah [1 ]
Khoubila, Nisrine [1 ]
机构：
[1] Ctr Hosp Univ Ibn Rochd Casablanca, Fac Med & Pharm Hassan II, Serv Hematol Clin, Casablanca, Morocco
[2] Ctr Hosp Univ Ibn Rochd Casablanca, Fac Med & Pharm Hassan II, Serv Anat Pathol, Casablanca, Morocco
来源：
PAN AFRICAN MEDICAL JOURNAL | 2024年 / 49卷
关键词：
AL amyloidosis; follicular lymphoma; progression; treatment; case report; SYSTEMIC AMYLOIDOSIS; AL AMYLOIDOSIS;
D O I：
10.11604/pamj.2024.49.128.43592
中图分类号：
R1 [预防医学、卫生学];
学科分类号：
1004 ; 120402 ;
摘要：
The association of light-chain (AL) amyloidosis with type B follicular lymphoma is extremely rare, as the clone secreting the amyloidogenic light chain is generally plasmacytic. We here report the case of a 67-year-old patient with no specific pathological history, presenting with a deterioration in general condition, progressively worsening dysphonia and dysphagia, and a large mass in the cavum. Biopsy findings indicated grade 1-2 type-B follicular non-Hodgkin's lymphoma. Cervico thoraco-abdomino-pelvic computed tomography (CT) scan revealed a nasopharyngeal mass measuring 70 mm x 40 mm and extending over 60 mm. Bone marrow biopsy and pre-therapeutic evaluations were normal. The patient received 4 cycles of rituximab plus CHOP (cyclophosphamide, adriamycine, prednisone and oncovin) with no response, followed by 3 cycles of rituximab plus DHAOX (dexamethasone, high-dose cytarabine and oxalipatin) with persistence of the mass. A subsequent biopsy of the mass revealed the disappearance of B-cell lymphoid infiltration but showed AL kappa chain amyloid deposits. Immunoelectrophoresis of plasma proteins detected the presence of IgM kappa immunoglobulin. Positron emission tomography (PET) imaging identified a hypermetabolic nasopharyngeal process. The patient is currently undergoing treatment with a protocol combining bortezomib, prednisone, and bendamustine.
引用
收藏
页数：7
相关论文
共 10 条
  • [1] Sanchorawala V, Blanchard E, Seldin DC, Hara C, Skinner M, Wright DG., AL amyloidosis associated with B cell lymphoproliferative disorders: frequency and treatment outcomes, Am J Hematol, 81, 9, pp. 692-695, (2006)
  • [2] Telio D, Bailey D, Chen C, Crump M, Reece D, Kukreti V., Two distinct syndromes of lymphoma-associated AL amyloidosis: a case series and review of the literature, Am J Hematol, 85, 10, pp. 805-808, (2010)
  • [3] Kourelis TV, Gertz M, Zent C, Lacy M, Kyle R, Kapoor P, Et al., Systemic amyloidosis associated with chronic lymphocytic leukemia/small lymphocytic lymphoma, Am J Hematol, 88, 5, pp. 375-378, (2013)
  • [4] Terrier B, Jaccard A, Harousseau JL, Delarue R, Tournilhac O, Hunault-Berger M, Et al., The clinical spectrum of IgM-related amyloidosis: a French nationwide retrospective study of 72 patients, Medicine (Baltimore), 87, 2, pp. 99-109, (2008)
  • [5] Matsumoto Y, Masuda T, Nishimura A, Horie H, Harada K, Yoshida M, Et al., A case of AL amyloidosis associated with follicular lymphoma with plasmacytic differentiation, Int J Hematol, 111, 2, pp. 317-323, (2020)
  • [6] Sachchithanantham S, Roussel M, Palladini G, Klersy C, Mahmood S, Venner CP, Et al., European Collaborative Study Defining Clinical Profile Outcomes and Novel Prognostic Criteria in Monoclonal Immunoglobulin M-Related Light Chain Amyloidosis, J Clin Oncol, 34, 17, pp. 2037-2045, (2016)
  • [7] Basset M, Defrancesco I, Milani P, Nuvolone M, Rattotti S, Foli A, Et al., Nonlymphoplasmacytic lymphomas associated with light-chain amyloidosis, Blood, 135, 4, pp. 293-296, (2020)
  • [8] Wechalekar AD, Chakraborty R, Lentzsch S., Systemic Amyloidosis due to Low-Grade Lymphoma, Hematol Oncol Clin North Am, 34, 6, pp. 1027-1039, (2020)
  • [9] Sissoko M, Sanchorawala V, Seldin D, Sworder B, Angelino K, Broce M, Et al., Clinical presentation and treatment responses in IgM-related AL amyloidosis, Amyloid, 22, 4, pp. 229-235, (2015)
  • [10] Chaulagain CP., Utility of Bruton's Tyrosine Kinase Inhibitors in Light Chain Amyloidosis Caused by Lymphoplasmacytic Lymphoma (Waldenström's Macroglobulinemia), Adv Hematol, 2022, (2022)
1