A case of non-Hodgkin's lymphoma with macroglobulinemia

A case of non-Hodgkin's lymphoma with macroglobulinemia is reported. A 48-year-old man consulted our hospital with complaints of dysphagia and sleep apnea. On the first examination, degree III hypertrophy of tonsils, Bence-Jones protein of K-type on urinalysis, and an M-peak in the gamma-glb. similar to beta-glb. areas on fractionation of protein were found. Of serum immunoglobulins, IgM was increased markedly with 3,946 mg/dl and about 30% atypical lymphocytes were noted in the bone marrow. Bilateral tonsillectomy was carried out. The diagnosis of malignant lymphoma, non-Hodgkin, follicular, medium-sized cell type, B cell (sm IgM, kappa) was made by immunostaining of tissues. Chemotherapy was made after operation, and IgM levels decreased gradually. At present, the patient is following a satisfactory postoperative course, showing no swelling of tonsil.