Monoclonal Gammopathies Associated with Malignant Lymphomas

Lymphomas with a monotonous cellular pattern are occasionally associated with monoclonal gammopathies. There is still a controversy about tire site of the paraprotein production in these cases. Some investigators believe that the abnormal protein is produced directly by the lymphoma; others believe that it is produced in plasma cells and plasmacytoid lymphocytes as in Waldenstrom’s macroglobulinemia and heavy chain disease. Two cases of the poorly-differentiated lymphocytic type of malignant lymphoma associated with monoclonal gammopathies were studied by the immunofluorescent technic. Production of immunoglobulin could not be detected in the lymphoma in either case. Numerous cells containing immunoglobulin were found in the blood as well as bone marrow of both patients and also in the spleen of one. These findings suggest that the lymphomas with the monotonous cell patterns are not where paraprotein is produced. Although occasional plasmacytoid lymphocytes containing immunoglobulin may be found in the lymphoma, most are found in sites uninvolved by the neoplasm.