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Giant lymph node hyperplasia with osteoblastic bone lesions and the POEMS (takatsuki's) syndrome
Author(s) -
Bitter Mitchell A.,
Komaiko William,
Franklin Wilbur A.
Publication year - 1985
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19850701)56:1<188::aid-cncr2820560132>3.0.co;2-z
Subject(s) - medicine , organomegaly , poems syndrome , pathology , hepatosplenomegaly , population , anasarca , lymph node , polyneuropathy , disease , environmental health
A 38‐year‐old black man with giant lymph node hyperplasia (GLH), osteoblastic lesions, and the POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes) was treated at the University of Chicago Hospitals. The patient had hepatosplenomegaly and generalized peripheral lymphadenopathy. Endocrinologic abnormalities included decreased testosterone with elevated luteinizing hormone and follicle‐stimulating hormone, as well as hyperprolactinemia and possible hypothyroidism. Biopsy of a right femoral lymph node revealed GLH, and an osteoblastic pelvic lesion showed a marked lymphoplasmacytic infiltrate. By immunohistochemical techniques, plasma cells in the lymph node and osteoblastic lesion were polyclonal. A polyclonal hypergammaglobulinemia was present. The lymph node T‐lymphocyte population showed a decreased helper‐to‐suppressor cell ratio. Other findings included thickening of the skin, finger clubbing, and anasarca. A severe sensory‐motor polyneuropathy was the major factor contributing to the patient's death. The association of GLH, osteoblastic bone lesions, and the POEMS syndrome has been noted previously in Japan; however, the authors are unaware of reports on Western patients who had this combination of clinical and laboratory findings.