Peritoneal mesothelioma associated with polyclonal hyperimmunoglobulinemia

Our plain-English summary of Peritoneal mesothelioma associated with polyclonal hyperimmunoglobulinemia, by S. Onodera, R. Inaba, K. Niikawa, et al (The Tohoku Journal of Experimental Medicine, 1974).

The study

• Authors: S. Onodera, R. Inaba, K. Niikawa, K. Oikawa, K. Yoshinaga
• Journal: The Tohoku Journal of Experimental Medicine
• Published: 1974;114(3):195-203
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

This patient had marked polyclonal hyperimmunoglobulinemia associated with mesothelioma in the right subphrenic space. Histopathologically the lymph nodes around the mesothelioma showed marked plasma cell proliferation intermingled with infiltration of mesothelioma cells. The plasma cell proliferation was observed even in distant lymph nodes not infiltrated by the tumor cells. The review of the literature disclosed rather frequent occurrences of hyperimmunoglobulinemia in mesothelioma and significance of this association should be stressed.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This was a case report of one patient at Tohoku University Hospital, Japan. He was a 20-year-old Japanese male clerk admitted in May 1972 with fever and upper abdominal pain. The authors reported that he had no history of exposure to asbestos. His blood showed a large, rising, polyclonal excess of gamma globulin. At admission, gamma globulin was 53.9% of a total serum protein of 8.3 g/100 ml. It later reached 68.9% of 12.4 g/100 ml. Extensive tests did not find the underlying disease, and he was treated for probable tuberculous peritonitis. He died in December 1972. Autopsy found epithelial-type mesothelioma under the right diaphragm, spread to nearby lymph nodes. Distant lymph nodes had no tumor, but showed proliferation of plasma cells. The authors found 3 published reports of mesothelioma with raised blood globulins: one had been reported as monoclonal, which the authors questioned, and one involved multiple myeloma. They concluded that mesothelioma cell infiltration may cause plasma cell proliferation and excess immunoglobulin production, and said the mechanism awaited further study.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient, with a brief review of published cases)
• Who was studied: One 20-year-old Japanese male clerk admitted to Tohoku University Hospital, Sendai, on May 29, 1972; he died on December 13, 1972
• Exposure: No asbestos exposure was reported; the authors state the patient had no history of exposure to asbestos
• Main results:
  • In this patient at admission, serum total protein was 8.3 g/100 ml, with 53.9% gamma globulin
  • In this patient, the gamma globulin elevation persisted and increased, reaching 68.9% of total serum protein, which became 12.4 g/100 ml
  • In this patient, immunoelectrophoresis showed that the hypergammaglobulinemia was polyclonal
  • This patient was treated with anti-tuberculous agents on a probable diagnosis of tuberculous peritonitis
  • In this patient, the underlying disease was not found during life, and mesothelioma was found only at autopsy
  • In this patient, autopsy showed numerous tumors in the right subphrenic space, classified as mesothelioma of epithelial type
  • In this patient, the tumor had spread to neighboring lymph nodes but not to distant lymph nodes or other organs
  • In this patient, distant lymph nodes showed plasma cell proliferation even without tumor spread
  • In the published literature, the authors found 3 additional cases of mesothelioma with hypergammaglobulinemia
  • Of these published cases, one was reported as monoclonal gammopathy with malignant mesothelioma; the authors questioned whether it was really monoclonal rather than polyclonal
  • Another of these published cases was pleural mesothelioma associated with multiple myeloma
• The authors' conclusion: The authors concluded that this case, together with 3 earlier reported cases, may suggest that mesothelioma cell infiltration can cause plasma cell proliferation in the lymphoreticular system and lead to excessive immunoglobulin production
• Limitations the authors state:
  • The authors state that the precise mechanism of the plasma cell proliferation was not determined: whether it comes from antigenic or mechanical stimulation awaits further studies
  • The authors note that most earlier mesothelioma case reports lacked detailed serum protein analysis

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Mesothelioma.

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