Plasma cell myeloma is known to cause expansion of a single clone of munoglobulin (Ig) which results in the secretion of a unique homogeneous monoclonal protein (M component). However, there are cases which reported that it can also cause production of two different clones of these monoclonal proteins. Although it is relatively very rare as the prevalence is only 2% of all plasma cell myeloma cases, the clinical features are said to be similar to monoclonal gammopathy. It is suggested that these biclonal gammopathy results from either one monoclonal cell clone in monoclonal gammopathy or two different monoclonal cell clones. Whichever the mechanism of the disease be, the response to treatment seems to be similar as compared to the monoclonal cases although some reports shows chemoresistant. Here, we report a rare case of plasma cell myeloma with IgG (lambda) and IgA (lambda) type of biclonal gammopathy, the clinical presentation, the haematological and biochemical markers as well as the response to the treatment.
Keywords: biclonal gammopathy, M protein, plasma cell myeloma
Burkitt's lymphoma is a form of Non-Hodgkin's B-cell lymphoma. We report a case of Burkitt's lymphoma mimicking peritoneal carcinomatosis. We will discuss the imaging and clinical findings that differentiate between peritoneal carcinomatosis and Burkitt's lymphoma. A 26-year-old man presented with nonspecific abdominal pain, vomiting and diarrhea associated with significant amount of loss of weight. Computed tomography images showed extensive peritoneal and mesenteric mass associated generalized lymphadenopathy. Core biopsy of the mass confirmed Burkitt's lymphoma. CT scan features are helpful indicator to differentiate Burkitt's lymphoma and peritoneal carcinomatosis. Focal or diffuse nodular thickening of the bowel wall with extensive lymphadenopathy are likely to be lymphomatosis over carcinomatosis. However, final and confirmatory diagnosis is histopathology examination.
We examined the donor factors that may affect the yield of peripheral blood stem cell (PBSC) mobilized from healthy donors. Pre-apheresis PB-CD34(+) cell count was the only factor that correlated with PBSC yield. Leukocyte count (LC) and monocyte count (MC) correlated with PB-CD34(+) cell. Male gender and PB-CD34(+) cell count of at least 87.1/μL and 69.8/μL on day-4 and -5 of G-CSF were associated with the ability to harvest at least 5×10(6)/kg CD34(+) cells after one apheresis. We concluded that gender and PB-CD34(+) cell count are important predictors of PBSC yield. LC and MC may serve as surrogate markers for estimating the PB-CD34(+) cell count.