ArticleThe Pan African medical journal2024
[Amyloid light-chain (AL) amyloidosis and follicular lymphoma: a case report].
Article in The Pan African medical journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The association of light-chain (AL) amyloidosis with type B follicular lymphoma is extremely rare, as the clone secreting the amyloidogenic light chain is generally plasmacytic. We here report the case of a 67-year-old patient with no specific pathological history, presenting with a deterioration in general condition, progressively worsening dysphonia and dysphagia, and a large mass in the cavum. Biopsy findings indicated grade 1-2 type-B follicular non-Hodgkin's lymphoma. Cervico-thoraco-abdomino-pelvic computed tomography (CT) scan revealed a nasopharyngeal mass measuring 70 mm x 40 mm and extending over 60 mm. Bone marrow biopsy and pre-therapeutic evaluations were normal. The patient received 4 cycles of rituximab plus CHOP (cyclophosphamide, adriamycine, prednisone and oncovin) with no response, followed by 3 cycles of rituximab plus DHAOX (dexamethasone, high-dose cytarabine and oxalipatin) with persistence of the mass. A subsequent biopsy of the mass revealed the disappearance of B-cell lymphoid infiltration but showed AL kappa chain amyloid deposits. Immunoelectrophoresis of plasma proteins detected the presence of IgM kappa immunoglobulin. Positron emission tomography (PET) imaging identified a hypermetabolic nasopharyngeal process. The patient is currently undergoing treatment with a protocol combining bortezomib, prednisone, and bendamustine.
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